Provider Demographics
NPI:1306869607
Name:KIMBERLY SCHMID, MD PA
Entity type:Organization
Organization Name:KIMBERLY SCHMID, MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:K
Authorized Official - Last Name:SCHMID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:620-343-2500
Mailing Address - Street 1:1602 W 15TH AVE # F
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-9803
Mailing Address - Country:US
Mailing Address - Phone:620-343-2500
Mailing Address - Fax:620-343-2828
Practice Address - Street 1:1602 W 15TH AVE # F
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-9803
Practice Address - Country:US
Practice Address - Phone:620-343-2500
Practice Address - Fax:620-343-2828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-27403207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS103267OtherBC/BS OF KANSAS
KS169622OtherCOVENTRY INSURANCE
KS100178OtherHPK INSURANCE
KS2086174402Medicaid
KS103267Medicare ID - Type Unspecified