Individual provider Active NPI

Dana A Kimbrell, NP-C

  • Family Nurse Practitioner
  • Dover, OH
National Provider Identifier
1154887677
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.024661 Issued in OH
Practice address
407 W 7TH St
Dover, OH 44622-2813
Phone
(330) 432-5750
NPI assigned
Feb 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X LE-00026665 OH
Family Medicine Physician 207Q00000X 024661 OH
Family Nurse Practitioner 363LF0000X APRN.CNP.024661 OH Primary

Addresses

Primary practice location

407 W 7TH St
Dover, OH 44622-2813

Mailing address

407 W 7TH St
Dover, OH 44622-2813
Phone (330) 432-5750

Other identifiers 1

IdentifierTypeStateIssuer
207Q00000XMedicaidOH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240702002525 OH Practitioner - Nurse Practitioner 6103360060 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
024661OHMDFamily Medicine Physician
LE-00026665OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC Single Specialty CurrentSince May 8, 2024 Accepting new patients

Locations

175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1154887677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 W 7TH ST",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222813",
            "telephone_number": "330-432-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 W 7TH ST",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222813",
            "telephone_number": "330-432-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBRELL",
        "first_name": "DANA",
        "middle_name": "A",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-20",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "LE-00026665",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "024661",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.024661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207Q00000X",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, OH

Sources for this page

Verify at the official NPI Registry.