Deneal Kimball, QMHS
Individual provider Active NPI Case Manager/Care Coordinator · Bainbridge, OH
NPI 1104456664 · NPPES record last updated Jan 23, 2020
Key facts
- NPI
- 1104456664
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 1071 Tong Hollow Rd
Bainbridge, OH 45612-1500 - Phone
- (740) 634-3094
- NPI assigned
- Jan 23, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lighthouse Youth Services Inc. | Past |
Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/lys/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
1071 Tong Hollow Rd
Bainbridge, OH 45612-1500
Mailing address
401 E McMillan St
Cincinnati, OH 45206-1922
Phone (513) 221-3350
Other providers in Bainbridge, OH
- Japheth Johnson
- Kelsey Johnson
- Linda Jane Johnson
- Stanley M Johnson
- Kacy Lynn-Marie Juanchi
- Rosalie Renae King
- Jamie Kingery
- Logan Joseph Knauff
- Knisley Pharmacy Limited
- Paul Koehler
All providers in Bainbridge, OH · Case Manager/Care Coordinator in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.