Individual provider Active NPI

Kimberly Burkhart, PHD

  • Psychologist
  • Toledo, OH
National Provider Identifier
1437430774
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
7127 Issued in OH
Practice address
3130 Glendale Ave
Toledo, OH 43614
Phone
(419) 383-3815
Fax
(419) 383-3098
NPI assigned
Aug 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 7127 OH Primary

Addresses

Primary practice location

3130 Glendale Ave
Toledo, OH 43614

Mailing address

PO Box 3355
3Rd Floor
Toledo, OH 43607-0355
Phone (419) 383-4460

Other identifiers 1

IdentifierTypeStateIssuer
0099356MedicaidOH

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140402001986 OH Practitioner - Clinical Psychologist 4789815820 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Medical Group Inc CurrentSince Jun 1, 2016 Accepting new patients

Locations

11100 Euclid Ave
Cleveland Heights, OH 44106

20800 Harvard Rd
Fl 2
Highland Hills, OH 44122
Phone (216) 358-2156

Interoperability endpoints

  • Direct secure messaging: kburkhart36311@ehrdirect.uhhospitals.org

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": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462752000000",
    "number": "1437430774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3355",
            "address_2": "3RD FLOOR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436070355",
            "telephone_number": "419-383-4460",
            "fax_number": "419-383-3159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 GLENDALE AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43614",
            "telephone_number": "419-383-3815",
            "fax_number": "419-383-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHART",
        "first_name": "KIMBERLY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2016-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "7127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0099356",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.