Kimberly Ann Whittington, CPRS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

APS004860 Issued in OH

Practice address

120 Infirmary Rd
Dayton, OH 45417-8703

Phone

(937) 515-7094

NPI assigned

Apr 15, 2024

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

Other names 1

• Kimberly Pack Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1508610833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 INFIRMARY RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454178703",
            "telephone_number": "937-515-7094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 INFIRMARY RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454178703",
            "telephone_number": "937-515-7094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTINGTON",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "CPRS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "APS004860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "PACK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Danielle Renee Whitsel, CNP
• Joshua J Whitt, PT
• Kyle Whitt
• Tamara D Whitt, SRNA
• Chelsea Rae Whittington, CPRS
• Samantha Whittington
• Giana Monique Whorton
• Luke Wibowo, MD
• Daniel Wick
• Tracy Katherine Wick, MD

• Peer Specialist in Dayton, OH
• Providers in Dayton, OH by specialty
• Peer Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.