BETH C KIMBALL (NPI# 1508806357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508806357 |
| Entity Type | Individual |
| Full Name | BETH C KIMBALL |
| Credential | MD |
| Practice Address |
5325 Elliott Dr Suite 104 Ypsilanti MI 48197-8633 |
| Practice Telephone | 7347128150 |
| Practice Fax Number | 7347128151 |
| Mailing Telephone | 7347128150 |
| Mailing Fax Number | 7347128151 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2012-09-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 4301056106 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4146934-10 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013465244 | Beth Kimball | Physical Therapist | 801 W Judge Perez Dr, Suite A, Chalmette, LA 70043-4882 | 2016-09-16 |
| Street Address |
5325 ELLIOTT DR SUITE 104 |
| City | YPSILANTI |
| State | MI |
| Zip Code | 48197-8633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245237387 | Susan R. Illikman | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2005-07-05 |
| 1710533799 | Catherine I Giles | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2019-08-14 |
| 1083102214 | Christine Glowacki | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2018-04-24 |
| 1619488384 | Elizabeth H Stalder | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197 | 2017-10-20 |
| 1609312420 | Terri Lynn Trombley | Registered Nurse | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2017-01-18 |
| 1235685041 | Diana Rego | Nurse Practitioner | 5325 Elliott Dr, Suite 104, Ypsilanti, MI 48197-8633 | 2016-08-31 |
| 1184170524 | Cristina Hauncher | Dietitian, Registered | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2016-08-26 |
| 1629524194 | Zachary Ryan York | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2016-08-25 |
| 1225583362 | Kathleen Ritzert | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2016-08-18 |
| 1902359094 | St Joseph Mercy Hospital | Clinic/Center | 5325 Elliott Dr, Sutie 105, Ypsilanti, MI 48197-8633 | 2016-07-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700423092 | Devika Dibya Choudhuri | Counselor | 135 Porter West Circle Drive, Ypsilanti, MI 48197 | 2019-12-05 |
| 1770128837 | Brian Lee Shue | Registered Nurse | 6277 Maplehurst Dr, Ypsilanti, MI 48197 | 2019-11-13 |
| 1639721566 | Darlene E Bellers | 845 W. Circle Dr, Suite 160, Ypsilanti, MI 48197 | 2019-07-11 | |
| 1073165874 | Eastern Michigan University | Dietitian, Registered | Suite 160 Rackham, Ypsilanti, MI 48197 | 2019-07-11 |
| 1447815469 | Rainbow Rehabilitation Centers, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6200 Textile Rd, Ypsilanti, MI 48197 | 2019-05-06 |
| 1417416298 | Justin Brewer | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Drive Suite 2115, Ypsilanti, MI 48197 | 2019-03-19 |
| 1124519780 | Great Lakes Mindfulness LLC | Community/Behavioral Health | 4007 Carpenter Rd # 280, Ypsilanti, MI 48197 | 2018-05-19 |
| 1841799715 | Bedside Angel's Home Care, LLC | Home Health | 2032 S. Congress Street, Ypsilanti, MI 48197 | 2018-02-06 |
| 1891211777 | Brandon James Kukal | Specialist/Technologist | 799 N Hewitt, Ypslinati, MI 48197 | 2017-08-22 |
| 1669908737 | Michael Bekkerman | Student in an Organized Health Care Education/Training Program | 5303 Elliot Drive, Cancer Center, Ypsilanti, MI 48197 | 2017-05-10 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639299209 | Seema Kapur | Surgery | 5333 Mcauley Dr Ste 104, Ypsilanti, MI 48197-1014 | 2007-03-29 |
| 1922062538 | Tara M Breslin | Surgery | 5320 Elliott Dr, Suite 203, Ypsilanti, MI 48197-1032 | 2006-04-12 |
| 1194720284 | Gregory J Cerilli | Surgery | 5301 E. Huron River Dr., Ypsilanti, MI 48197 | 2005-06-16 |
| 1235659574 | Iha Health Services Corporation | Surgery | 5301 E. Huron River Dr., Ypsilanti, MI 48197 | 2017-06-27 |
| 1932638145 | Midwest Management Company, LLC | Surgery | 135 S Prospect St, Ypsilanti, MI 48198-7914 | 2017-06-09 |
| 1134548696 | Blake Ryan Movitz | Surgery | 135 S Prospect St, Ypsilanti, MI 48198-7914 | 2014-04-14 |
| 1194167049 | Beth-ann Shanker | Surgery | 5325 Elliott Dr, Suite 104, Ypsilanti, MI 48197-8633 | 2013-07-20 |
| 1013266956 | Jamokay Taylor PC | Surgery | 135 S Prospect St, Ypsilanti, MI 48198-7914 | 2012-09-06 |
| 1982962213 | Katherine Petrin | Surgery | 5333 Mcauley Dr, Suite 2115, Ypsilanti, MI 48197-1014 | 2012-04-24 |
| 1497038343 | St Joseph Mercy Hospital | Surgery | 5320 Elliott Dr, Suite 203, Ypsilanti, MI 48197-1032 | 2011-09-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.