Kimberly M Bushrow, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50001455 Issued in OH

Practice address

1100 W Main St
Woodville, OH 43469-9723

Phone

(419) 724-5820

Fax

(419) 724-5821

NPI assigned

Oct 7, 2005

Last updated

Sep 17, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH, MI2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Toledo Clinic PLLCGroup PAC ID 8426585142, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Toledo Clinic PLLC

  • Dermatology Physician
  • Wauseon, OH
  • NPI 1326538703

  MI

  Medicare reassignment Care Compare group
• Toledo Clinic Incorporated

  • Surgery Physician
  • Toledo, OH
  • NPI 1144217894
  Medicare reassignment NPD
• Toledo Clinic Incorporated

  • Internal Medicine Physician
  • Monroe, MI
  • NPI 1669423455
  Medicare reassignment NPD
• Toledo Clinic Incorporated

  • Clinical Medical Laboratory
  • Toledo, OH
  • NPI 1114079167
  NPD
• Toledo Clinic Incorporated

  • Podiatrist
  • Sylvania, OH
  • NPI 1952097073
  NPD
• Toledo Clinic PLLC

  • Dermatology Physician
  • Lambertville, MI
  • NPI 1700842796
  NPD
• Observation Physicians of Northwest Ohio LLC

  • Emergency Medicine Physician
  • Toledo, OH
  • NPI 1700462967
  NPD (past)
• Promedica Central Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1043270150

  Physician Assistant

  NPD (past)
• DPT Holdings, LLC

  dba Doctors of Physical Therapy

  • Physical Therapist
  • Plainfield, IL
  • NPI 1689648602
  NPD (past)

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1154319820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 SECOR RD",
            "city": "LAMBERTVILLE",
            "state": "MI",
            "postal_code": "481449737",
            "telephone_number": "419-479-5795",
            "fax_number": "419-479-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W MAIN ST",
            "city": "WOODVILLE",
            "state": "OH",
            "postal_code": "434699723",
            "telephone_number": "419-724-5820",
            "fax_number": "419-724-5821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7301 Secor Rd",
            "address_purpose": "LOCATION",
            "city": "Lambertville",
            "state": "MI",
            "postal_code": "481449737",
            "country_code": "US",
            "telephone_number": "419-479-5795",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "341 Trenton Ave",
            "address_purpose": "LOCATION",
            "city": "Findlay",
            "state": "OH",
            "postal_code": "458403745",
            "country_code": "US",
            "telephone_number": "567-250-8212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1090 N Shoop Ave",
            "address_purpose": "LOCATION",
            "city": "Wauseon",
            "state": "OH",
            "postal_code": "435671821",
            "country_code": "US",
            "telephone_number": "419-330-5200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "106 S Lafayette St",
            "address_purpose": "LOCATION",
            "city": "South Lyon",
            "state": "MI",
            "postal_code": "481781404",
            "country_code": "US",
            "telephone_number": "947-348-1176",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "417 4th St",
            "address_purpose": "LOCATION",
            "city": "Defiance",
            "state": "OH",
            "postal_code": "435122605",
            "country_code": "US",
            "telephone_number": "419-785-4660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1136 Country Club Rd Unit C",
            "address_purpose": "LOCATION",
            "city": "Adrian",
            "state": "MI",
            "postal_code": "492218209",
            "country_code": "US",
            "telephone_number": "517-366-5110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1070 N Shoop Ave",
            "address_purpose": "LOCATION",
            "city": "Wauseon",
            "state": "OH",
            "postal_code": "435671821",
            "country_code": "US",
            "telephone_number": "419-330-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSHROW",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-07",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50001455",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003621",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0084436",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Kaye Arden, BSN, RN, CRRN
• Jena Sue Bahnsen-Wright
• Telia Raeann Boice
• Michael Robert Brocke, M.D.
• Jennifer Kay Burner
• Amanda Nicole Cousino, LPN
• Glen Andrew Davis, DDS
• Ashley Marie Frank, M.S., CF-SLP
• Christopher James Frazier, PHARM.D.
• Stephanie Renee Frobose, FNP-C

• Physician Assistant in Woodville, OH
• Providers in Woodville, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; 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.