KIMBERLY SUSAN O'DONNELL (NPI# 1962591107) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962591107 |
| Entity Type | Individual |
| Full Name | KIMBERLY SUSAN O'DONNELL |
| Credential | MD |
| Practice Address |
4260 Plymouth Rd Ann Arbor MI 48109-2700 |
| Mailing Address |
3621 S State St Ann Arbor MI 48108-1633 |
| Practice Telephone | 7346475670 |
| Mailing Telephone | 7346475299 |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-10-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 4301078179 | MI | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 4301078179 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4765594 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497115745 | Kimberly O'donnell | Occupational Therapist | 1095 Beauty Hill Rd, Barnstead, NH 03218-3750 | 2016-02-29 |
| 1497273429 | Kimberly A O'donnell | Nurse Practitioner | 5742 Booth Rd Ste A, Jacksonville, FL 32207-5982 | 2017-08-30 |
| 1386910941 | Kimberly A O'donnell | Rehabilitation Practitioner | 14535 Sherman Cir, Van Nuys, CA 91405-3087 | 2012-03-28 |
| Street Address |
4260 PLYMOUTH RD |
| City | ANN ARBOR |
| State | MI |
| Zip Code | 48109-2700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497748537 | Henry Lauris Paulson | Psychiatry & Neurology | 4260 Plymouth Rd, Ann Arbor, MI 48109-2700 | 2005-08-24 |
| 1487270997 | Anirudh Goyal | Student in an Organized Health Care Education/Training Program | 4260 Plymouth Rd, Ann Arbor, MI 48109-2700 | 2020-06-20 |
| 1902421001 | Bhushan Deshpande | Student in an Organized Health Care Education/Training Program | 4260 Plymouth Rd, Ann Arbor, MI 48109-2700 | 2020-06-15 |
| 1477178580 | Danielle Devlin | Student in an Organized Health Care Education/Training Program | 4260 Plymouth Rd, Ann Arbor, MI 48109-2700 | 2020-06-15 |
| 1902420110 | Melissa Ross | Student in an Organized Health Care Education/Training Program | 4260 Plymouth Rd, Ann Arbor, MI 48109-2700 | 2020-06-03 |
| 1699399881 | Stacy Lang | Student in an Organized Health Care Education/Training Program | 4260 Plymouth Rd, Ann Arbor, MI 48109-2700 | 2020-06-03 |
| 1205459559 | Bradley Disbrow | Student in an Organized Health Care Education/Training Program | 4260 Plymouth Rd, Ann Arbor, MI 48109-2700 | 2020-05-21 |
| 1356964704 | Ashlee Nicole Smith | Student in an Organized Health Care Education/Training Program | 4260 Plymouth Rd, Ann Arbor, MI 48109-2700 | 2020-05-20 |
| 1184247520 | Tatum Yvonne Zurawski | Student in an Organized Health Care Education/Training Program | 4260 Plymouth Rd, Ann Arbor, MI 48109-2700 | 2020-05-20 |
| 1841813318 | Karthik Padmanabhan | Student in an Organized Health Care Education/Training Program | 4260 Plymouth Rd, Ann Arbor, MI 48109-2700 | 2020-05-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558987024 | Albert Byun | Student in an Organized Health Care Education/Training Program | 1500 E.medical Center Dr., 1h247, Ann Arbor, MI 48109 | 2020-06-22 |
| 1851914931 | Nadine Ibrahim | Student in an Organized Health Care Education/Training Program | 1500 E. Medical Center Drive, Spc 5312, Taubman Center, 1st Floor, Room 1903, Ann Arbor, MI 48109 | 2020-05-22 |
| 1568083350 | Tucker Zimmer | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Dr, Uh South F-6245, Ann Arbor, MI 48109 | 2020-05-03 |
| 1144841099 | Jessica Moore Meves | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Drive, Uh South F-6245, Ann Arbor, MI 48109 | 2020-05-01 |
| 1710522297 | Xiaoyuan Hu | Specialist/Technologist | Obl 2150, 1402 Washington Hts, Ann Arbor, MI 48109 | 2019-11-08 |
| 1376192401 | Regina Kay Freeman | Clinical Nurse Specialist | 4726 Cardiovascular Center, 1500 E Medical Center Dr, Ann Arbor, MI 48109 | 2019-09-11 |
| 1477114155 | William Philip Saunders IIi | Student in an Organized Health Care Education/Training Program | 300 N Ingalls Building, Rm Ni4co6, Ann Arbor, MI 48109 | 2019-06-24 |
| 1093290447 | Teresa H Lyden | Speech-Language Pathologist | 1500 E. Medical Center Dr., Spc 5312, 1904 Tc, Otolaryngology-head and Neck Surgery, Ann Arbor, MI 48109 | 2018-10-02 |
| 1649755091 | Anna Grace Hardenbergh | Speech-Language Pathologist | 1500 E. Medical Center Drive Tc 1904, Otolaryngology Head and Neck Surgery, Ann Arbor, MI 48109 | 2018-10-02 |
| 1548754609 | Amy Wu | Pediatrics | 1500 East Medical Center Drive., Medical Professional Bldg. D-3238, Ann Arbor, MI 48109 | 2018-06-21 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003268954 | Laila Alia Gharzai | Internal Medicine | 1500 E Medical Center Dr Spc 5010, Ann Arbor, MI 48109 | 2016-07-04 |
| 1376993568 | Gurkirat Kaur Gill | Internal Medicine | 500 S State St, Ann Arbor, MI 48109-1382 | 2016-06-17 |
| 1700249026 | Michael Wayne Stevens | Internal Medicine | 1500 E Medical Center Dr Spc 5243, Ann Arbor, MI 48109-5243 | 2016-04-04 |
| 1518348697 | Linda Wang | Internal Medicine | 4260 Plymouth Rd Rm B1-313, Ann Arbor, MI 48109 | 2015-06-15 |
| 1922493956 | Debbie W Chen | Internal Medicine | 24 Frank Lloyd Wright Dr Ste 1300, Ann Arbor, MI 48105-9484 | 2015-04-06 |
| 1356735765 | Salma Shaikhouni | Internal Medicine | 1500 E Medical Center Dr Spc 53643914, Ann Arbor, MI 48109-5000 | 2015-03-24 |
| 1699172676 | David Noel O'dwyer | Internal Medicine | 1500 East Medical Centre Dr, 3rd Floor Taubman Center Recp C, Ann Arbor, MI 48109-4585 | 2014-11-19 |
| 1417375791 | Rebecca Hartog | Internal Medicine | 1540 E Hospital Dr Spc 4204, Ann Arbor, MI 48109 | 2014-04-03 |
| 1982022448 | Donald Alexander Perry | Internal Medicine | 1500 E Medical Center Dr, Spc 5226, F4132 University Hospital South, Ann Arbor, MI 48109-5226 | 2014-04-02 |
| 1578988598 | Downriver Medical Center, P.l.l.c. | Internal Medicine | 245 High Orchard Dr, Ann Arbor, MI 48105 | 2014-02-27 |
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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.