Individual provider Active NPI

Kimberly Navratil

  • Adult Health Clinical Nurse Specialist
  • Clyde, OH
National Provider Identifier
1417364936
Registry record updated Mar 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
COA.12352NS Issued in OH
Practice address
112 Independence Way
Suite 110
Clyde, OH 43410-9811
Phone
(419) 483-9000
Fax
(419) 483-9003
NPI assigned
Jul 16, 2014
Last updated
Mar 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X COA.12352NS OH Primary

Addresses

Primary practice location

112 Independence Way
Suite 110
Clyde, OH 43410-9811

Mailing address

PO Box 378
Sandusky, OH 44871-0378
Phone (419) 609-1112

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
I20141204002006 OH Practitioner - Certified Clinical Nurse Specialist (CNS) 1254653009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Coast Professional Company, LLCGroup PAC ID 6305810201, 105 clinicians

Practice addresses (Care Compare)

3960 E Harbor Rd
Port Clinton, OH 43452-2670
Phone (419) 732-0700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.12352NSOHMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
North Coast Professional Company, LLC CurrentSince Aug 28, 2023 Accepting new patients
North Coast Professional Company, LLC CurrentSince Aug 28, 2023 Accepting new patients

Locations

3960 East Harbor Rd
Port Clinton, OH 43452
Phone (419) 557-5488

703 Tyler St
Ste 352
Sandusky, OH 44870
Phone (419) 557-6785

Interoperability endpoints

  • Direct secure messaging: kimberly.navratil@fpg.medicity.net
  • Direct secure messaging: knavratil20579@nomshealthcare.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458518400000",
    "number": "1417364936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 378",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448710378",
            "telephone_number": "419-609-1112",
            "fax_number": "419-609-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 INDEPENDENCE WAY",
            "address_2": "SUITE 110",
            "city": "CLYDE",
            "state": "OH",
            "postal_code": "434109811",
            "telephone_number": "419-483-9000",
            "fax_number": "419-483-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAVRATIL",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-16",
        "last_updated": "2016-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "OH",
            "license": "COA.12352NS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clyde, OH

Sources for this page

Verify at the official NPI Registry.