Active NPI
Kimberly Kay Mitchell, STNA
- Nurse's Aide
- Alliance, OH
National Provider Identifier
1316065147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 400237990503
- Practice address
- 13483 Beeson St NE
Suite #1
Alliance, OH 44601 - Phone
- (330) 823-4911
- Fax
- (330) 823-4911
- NPI assigned
- Mar 27, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 400237990503 | OH | Primary |
Addresses
Primary practice location
13483 Beeson St NE
Suite #1
Alliance, OH 44601
Mailing address
13483 Beeson St NE
#2
Alliance, OH 44601
Phone (330) 823-4911
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 400237990503 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 400237990503 | OH | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1316065147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13483 BEESON ST NE",
"address_2": "#2",
"city": "ALLIANCE",
"state": "OH",
"postal_code": "44601",
"telephone_number": "330-823-4911",
"fax_number": "330-823-4911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13483 BEESON ST NE",
"address_2": "SUITE #1",
"city": "ALLIANCE",
"state": "OH",
"postal_code": "44601",
"telephone_number": "330-823-4911",
"fax_number": "330-823-4911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "KIMBERLY",
"middle_name": "KAY",
"name_prefix": "Mrs.",
"credential": "STNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-27",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "OH",
"license": "400237990503",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "400237990503",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alliance, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.