Kerrena Nicole Gilmore, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

366684 Issued in OH

Practice address

10333 Northfield Rd Unit 74D
Northfield, OH 44067-1471

Phone

(330) 999-0370

Fax

(330) 777-8520

NPI assigned

Mar 1, 2021

Last updated

Mar 1, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

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.

• Professional Healthcare Solutions

  • Home Health Agency
  • Northfield, OH
  • NPI 1588089924
  NPD

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1306430459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10333 NORTHFIELD RD UNIT 74D",
            "city": "NORTHFIELD",
            "state": "OH",
            "postal_code": "440671471",
            "telephone_number": "330-999-0370",
            "fax_number": "330-777-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10333 NORTHFIELD RD UNIT 74D",
            "city": "NORTHFIELD",
            "state": "OH",
            "postal_code": "440671471",
            "telephone_number": "330-999-0370",
            "fax_number": "330-777-8520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10333 Northfield Rd Unit 74D",
            "address_purpose": "LOCATION",
            "city": "Northfield",
            "state": "OH",
            "postal_code": "440671471",
            "country_code": "US",
            "telephone_number": "330-990-0650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "KERRENA",
        "middle_name": "NICOLE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "366684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Connecturl",
            "affiliation": "N",
            "address_1": "1806 Curry Ln",
            "city": "Twinsburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440874308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer L Gale
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• Zev I Goldberg, PHD
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• Registered Nurse in Northfield, OH
• Providers in Northfield, OH by specialty
• Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.