DOUGLAS KIMMEL (NPI# 1891780631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891780631 |
| Entity Type | Individual |
| Full Name | DOUGLAS KIMMEL |
| Credential | D.O. |
| Practice Address |
23 Bustleton Pike Suite 100 Feasterville Trevose PA 19053-6446 |
| Mailing Address |
12265 Townsend Rd Philadelphia PA 19154-1201 |
| Practice Telephone | 2154649599 |
| Practice Fax Number | 2154647865 |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2016-11-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | OS006506L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | AETNA US HEATLHCARE | 98765 | 01 |
| PA | KEYSTONE HEALTH PLAN EAST | 0391404000 | 01 |
| PA | 100416C | 05 | |
| PA | PA BLUE SHIELD | 570038 | 01 |
| PA | 01767OS006506L | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750316543 | Douglas C Kimmel | Psychologist | 13 Captain Bill Road, Tamarack Place Suite 2, Hancock, ME 04640-0466 | 2006-07-11 |
| 1922044239 | Douglas J Kimmel | Radiology | 305 S State St, Aberdeen, SD 57401-4527 | 2006-06-22 |
| Street Address |
23 BUSTLETON PIKE SUITE 100 |
| City | FEASTERVILLE TREVOSE |
| State | PA |
| Zip Code | 19053-6446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609496918 | Kelly Beaumont | Nurse Practitioner | 23 Bustleton Pike, Feasterville Trevose, PA 19053-6446 | 2020-04-16 |
| 1376182725 | Briana Renois Antwi | Registered Nurse | 23 Bustleton Pike, Feasterville Trevose, PA 19053-6446 | 2020-01-02 |
| 1992244727 | Hr Physician Services | Orthopaedic Surgery | 23 Bustleton Pike, Ste 300, Feasterville Trevose, PA 19053-6446 | 2017-02-13 |
| 1699935957 | Andrew Matthews | Internal Medicine | 23 Bustleton Pike, Suite 100, Feasterville Trevose, PA 19053-6446 | 2008-06-11 |
| 1407921281 | Neelima M Kute | Family Medicine | 23 Bustleton Pike, Suite 200, Feasterville Trevose, PA 19053-6446 | 2006-11-21 |
| 1770660698 | Denise Keegan | Nurse Practitioner | 23 Bustleton Pike, Suite 200, Feasterville Trevose, PA 19053-6446 | 2006-11-01 |
| 1245248442 | Phillip Liaw | Internal Medicine | 23 Bustleton Pike, Suite 200, Feasterville Trevose, PA 19053-6446 | 2006-08-03 |
| 1679581870 | Mark Jay Mullen | Internal Medicine | 23 Bustleton Pike, Suite 200, Feasterville Trevose, PA 19053-6446 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710451539 | For Eyes Optical of Pa | Optometrist | 186 West Street Road, Feasterville, PA 19053 | 2019-01-15 |
| 1881181410 | Linda S Linden | Massage Therapist | 333 Steele Rd, Feasterville, PA 19053 | 2018-04-19 |
| 1336671619 | Marsela Ismailanji | Behavioral Analyst | 4 Neshaminy Interplex Drive, Suite 202, Trevose, PA 19053 | 2017-03-28 |
| 1194189019 | Kathleen A Gant | Nurse Practitioner | 4829 Street Rd, Trevose, PA 19053 | 2016-04-06 |
| 1801263165 | Kristi Ann Wert | Nurse Practitioner | 4829 E. Street Rd, Trevose, PA 19053 | 2015-08-21 |
| 1841675113 | Marlene Lisa Levis | Pharmacist | 176 West Street Road, Feasterville, PA 19053 | 2015-07-28 |
| 1578802229 | Colleen Joan Garneau | Registered Nurse | 2500 N Gate Rd, Trevose, PA 19053 | 2013-01-31 |
| 1225306376 | Michael J Fanelli | Pharmacist | 2 E. Street Rd, Feasterville, PA 19053 | 2011-12-05 |
| 1053689125 | Yuliya Peskin | Pharmacist | 2 E Street Road, Walgreens, Feasterville, PA 19053 | 2011-12-05 |
| 1891000584 | Justin T Jiunta | Physical Therapist | 1040 Mill Creek Drive, Feasterville, PA 19053 | 2010-08-18 |
| Find all providers in zip 19053 | ||||
| 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 |
|---|---|---|---|---|
| 1992192744 | Si Tien Lam | Family Medicine | 23 Bustleton Pike Ste 200, Feasterville Trevose, PA 19053-6446 | 2015-04-20 |
| 1225197718 | Jon Scott Fisher | Family Medicine | 157 Bustleton Pike # 161, Feasterville Trevose, PA 19053-6456 | 2006-12-08 |
| 1205839339 | John Bernard Junod | Family Medicine | 75 E Street Rd, Feasterville Trevose, PA 19053-6047 | 2005-05-23 |
| 1285034470 | Patient First Pennsylvania Medical Group Pllc | Family Medicine | 75 E Street Rd, Feasterville Trevose, PA 19053-6047 | 2014-08-26 |
| 1174951263 | Andria Marie Allen | Family Medicine | 75 E Street Rd, Feasterville Trevose, PA 19053-6047 | 2013-10-29 |
| 1467621953 | Kia Denise West | Family Medicine | 75 E Street Rd, Feasterville Trevose, PA 19053-6047 | 2008-02-28 |
| 1184800245 | Feasterville Family Practice, LLP | Family Medicine | 523 Bustleton Pike, Feasterville Trevose, PA 19053-6051 | 2008-01-18 |
| 1407921281 | Neelima M Kute | Family Medicine | 23 Bustleton Pike, Suite 200, Feasterville Trevose, PA 19053-6446 | 2006-11-21 |
| 1992887475 | Roberta L. Scherr | Family Medicine | 75 E Street Rd, Feasterville Trevose, PA 19053-6047 | 2006-10-20 |
| 1922189315 | Jeffry Alan Lindenbaum | Family Medicine | 75 E Street Rd, Feasterville Trevose, PA 19053-6047 | 2006-10-18 |
| Find all providers in FEASTERVILLE TREVOSE | ||||
| City | FEASTERVILLE TREVOSE |
| Zip Code | 19053 |
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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.