Nicole Jennifer Gallimore

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN.CNP.0030872 Issued in OH

Practice address

5982 Rhodes Rd
Kent, OH 44240-8100

Phone

(330) 673-1347

NPI assigned

Mar 9, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Serenity Center of Youngstown LLCGroup PAC ID 3870893472, 13 clinicians

Coleman Professional Services, Inc.Group PAC ID 2769474618, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Coleman Professional Services, Inc.

  • Mental Health Counselor
  • Kent, OH
  • NPI 1982637633

  OH

  Medicare reassignment Care Compare group NPD
• Serenity Center of Youngstown, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • North Lima, OH
  • NPI 1760861249

  OH

  Medicare reassignment Care Compare group NPD
• Family & Community Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Warren, OH
  • NPI 1750607057

  OH

  Medicare reassignment NPD
• Family & Community Services, Inc

  • Addiction (Substance Use Disorder) Counselor
  • Kent, OH
  • NPI 1952662108
  NPD
• CNP Operating Co LLC

  • Multi-Specialty Clinic/Center
  • Salisbury, MD
  • NPI 1518386739
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1134876121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5982 RHODES RD",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442408100",
            "telephone_number": "330-673-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5982 RHODES RD",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442408100",
            "telephone_number": "330-673-1347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5982 Rhodes Rd",
            "address_purpose": "LOCATION",
            "city": "Kent",
            "state": "OH",
            "postal_code": "442408100",
            "country_code": "US",
            "telephone_number": "330-673-1347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLIMORE",
        "first_name": "NICOLE",
        "middle_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-09",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0030872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth J Frye
• Kerry Larue Fuller
• Lauren Marie Fuller, M.ED., BCBA, COBA
• Danielle Elaine Furbee
• Future Self Nutrition LLC
• Christopher Gammon
• Lynnae Patricia Gandy
• Alexia A Gardi, LISW-S
• Stephanie Lynn Gardner
• Andrea Garner

• All providers in Kent, OH
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.