SEAN L KIMBALL (NPI# 1124169453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124169453 |
| Entity Type | Individual |
| Full Name | SEAN L KIMBALL |
| Credential | DO |
| Practice Address |
79 North St Granville Family Health Granville NY 12832-1137 |
| Mailing Address |
100 Park Street Glens Falls Hospital - Credentialing Glens Falls NY 12801-4413 |
| Practice Telephone | 5186420612 |
| Practice Fax Number | 5186420693 |
| Mailing Telephone | 5189265924 |
| Mailing Fax Number | 5189266983 |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2019-09-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 249528 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03028888 | 05 | |
| NY | RR MEDICARE | P00642757 | 01 |
| Street Address |
79 NORTH ST GRANVILLE FAMILY HEALTH |
| City | GRANVILLE |
| State | NY |
| Zip Code | 12832-1137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487645826 | Ann Marie Gregory | Nurse Practitioner | 79 North St, Granville Family Health, Granville, NY 12832-1137 | 2005-11-03 |
| 1881186930 | Brandy Lee Wadsworth | Registered Nurse | 79 North St, Granville, NY 12832 | 2018-06-05 |
| 1679093439 | Megan Amber Rozell | Physician Assistant | 79 North St, Granville, NY 12832-1137 | 2017-06-22 |
| 1467876409 | Mallory C Edwards | Physician Assistant | 79 North St, Granville, NY 12832-1137 | 2014-02-11 |
| 1619222759 | Glens Falls Hospital Inc | Pediatrics | 79 North St, Granville Family Health, Granville, NY 12832-1137 | 2012-07-16 |
| 1417211962 | North Country Sports Medicine Pllc | Orthopaedic Surgery | 79 North St, Granville, NY 12832-1137 | 2012-06-29 |
| 1306974845 | Cynthia Larrabee Short | Internal Medicine | 79 North St, Granville, NY 12832-1137 | 2007-02-28 |
| 1083665582 | Gordon M Thomas | Family Medicine | 79 North St, Granville Family Health Center, Granville, NY 12832-1137 | 2006-05-12 |
| 1174591796 | W Marvin Day | Physician Assistant | 79 North St, Granville Family Health, Granville, NY 12832-1137 | 2006-03-09 |
| 1477528537 | Eileen M Spillane | Family Medicine | 79 North St, Granville Family Health, Granville, NY 12832-1137 | 2006-02-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851769541 | Freds Pharmacy LLC | Pharmacy | 75 Quaker Street, Granville, NY 12832 | 2015-09-11 |
| 1013353796 | Bianca B. Bernard | Registered Nurse | 84 East Potter Avenue, Granville, NY 12832 | 2013-05-21 |
| 1659693166 | Courtney Alexis Washburn | Pharmacist | 116 Quaker St, Granville, NY 12832 | 2010-02-25 |
| 1720114564 | Arnold Small | Dentist | The Orchard Nursing and Rehabilitation Centre, 10421state Route40, Granville, NY 12832 | 2007-02-26 |
| 1609933423 | Granville Central School District | Local Education Agency (LEA) | 58 Quaker St, Granville, NY 12832 | 2007-01-02 |
| 1891880944 | Anne E Riker | Physician Assistant | 17 Madison Street, Granville, NY 12832 | 2006-10-04 |
| 1184933475 | Elizabethtown Community Hospital | General Acute Care Hospital | 66 Park Street, Suite 100, Elizabethtown, NY 12832-0000 | 2010-10-04 |
| 1942653852 | Laurie Ann Dennison | Registered Nurse | 15 Pine St, Granville, NY 12832-1111 | 2016-07-15 |
| 1952873259 | Michelle Parbus | Physician Assistant | 24 Pine St, Granville, NY 12832-1127 | 2018-12-26 |
| 1710371539 | 73 North of Granville, Inc. | Custodial Care Facility | 73 North St, Granville, NY 12832-1136 | 2015-03-19 |
| Find all providers in zip 12832 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710331715 | Navin Muni | Family Medicine | 1264 Weaver Drive, Granville, OH 43023 | 2016-04-16 |
| 1861733073 | Robert Paul Raker | Family Medicine | 176 Seymour Pl, Granville, OH 43023-1065 | 2013-03-13 |
| 1558697607 | Michael Lynch | Family Medicine | 19 Quaker St, Granville, NY 12832-1523 | 2009-10-26 |
| 1518970847 | Damian W Grivetti | Family Medicine | 309 S. Mccoy, Granville, IL 61326-9333 | 2006-08-15 |
| 1447363585 | Shawn E Bailey | Family Medicine | 309 South Mccoy Street, Granville, IL 61326 | 2006-08-15 |
| 1740227636 | Tracee Laing | Family Medicine | 494 N Granger St, Granville, OH 43023-1327 | 2006-06-01 |
| 1386681104 | Angela Eubanks | Family Medicine | 1945 Newark Granville Rd, Granville, OH 43023-9169 | 2006-06-01 |
| 1306803697 | David O. Parker | Family Medicine | 2790 Columbus Rd, Granville, OH 43023-1252 | 2006-04-28 |
| 1326046541 | Michael D Barth | Family Medicine | 1264 Weaver Dr, Granville, OH 43023-1257 | 2005-07-12 |
| 1659378115 | Patrick Joseph Scarpitti | Family Medicine | 2000 Newark Granville Rd, Suite 100, Granville, OH 43023-9135 | 2005-06-30 |
| Find all providers in GRANVILLE | ||||
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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.