Active NPI
Kimberly S Jarvie, CNP
- Women's Health Nurse Practitioner
- Kent, OH
National Provider Identifier
1508054115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 09677NP
- Practice address
- 1500 Eastway Dr
Kent, OH 44242-0001 - Phone
- (330) 672-2322
- Fax
- (330) 672-2272
- NPI assigned
- Oct 9, 2007
- Last updated
- Oct 11, 2021
- 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 |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 09677NP | OH | Primary |
Addresses
Primary practice location
1500 Eastway Dr
Kent, OH 44242-0001
Mailing address
1500 Eastway Dr
Kent, OH 44242-0001
Phone (330) 672-2322
Other names 1
- Kimberly S Myford
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09677NP | OH | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kent State University | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba KSU Deweese Health Center
- Student Health Clinic/Center
- Kent, OH
- NPI 1205871985
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633910400000",
"number": "1508054115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 EASTWAY DR",
"city": "KENT",
"state": "OH",
"postal_code": "442420001",
"telephone_number": "330-672-2322",
"fax_number": "330-672-2272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 EASTWAY DR",
"city": "KENT",
"state": "OH",
"postal_code": "442420001",
"telephone_number": "330-672-2322",
"fax_number": "330-672-2272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JARVIE",
"first_name": "KIMBERLY",
"middle_name": "S",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-09",
"last_updated": "2021-10-11",
"certification_date": "2021-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "OH",
"license": "09677NP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KIMBERLY",
"last_name": "MYFORD",
"middle_name": "S",
"credential": "CNP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Kent, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.