Individual provider Active NPI

Kimberlee Kay Herrmann, PA

  • Physician Assistant
  • Huron, SD
National Provider Identifier
1952383572
Registry record updated Aug 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
SD0335 Issued in SD
Practice address
33 3Rd St SE Ste 201
Huron, SD 57350-2064
Phone
(605) 353-0858
Fax
(605) 610-4063
NPI assigned
Nov 18, 2005
Last updated
Aug 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X SD0335 SD Primary

Addresses

Primary practice location

33 3Rd St SE Ste 201
Huron, SD 57350-2064

Mailing address

33 3Rd St SE Ste 201
Huron, SD 57350-2064
Phone (605) 353-0858

Other identifiers 1

IdentifierTypeStateIssuer
6822342MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
11095MNMDPhysical Therapist
SD0335SDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hoven Medical Clinic Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kimberlee.herrmann@avera.sdhealthlink.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1952383572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 3RD ST SE STE 201",
            "city": "HURON",
            "state": "SD",
            "postal_code": "573502064",
            "telephone_number": "605-353-0858",
            "fax_number": "605-610-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 3RD ST SE STE 201",
            "city": "HURON",
            "state": "SD",
            "postal_code": "573502064",
            "telephone_number": "605-353-0858",
            "fax_number": "605-610-4063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRMANN",
        "first_name": "KIMBERLEE",
        "middle_name": "KAY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "SD0335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6822342",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huron, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.