Kimberly Ann Nowack

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0031605 Issued in OH

Practice address

3780 Medina Rd
Medina, OH 44256-9311

Phone

(330) 721-7604

NPI assigned

Jun 27, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summa Physicians LLCGroup PAC ID 2961303532, 692 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Summa Physicians LLC

  • Obstetrics & Gynecology Physician
  • Akron, OH
  • NPI 1235167719
  Medicare reassignment Care Compare group NPD
• Summa Physicians LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Uniontown, OH
  • NPI 1457662769
  NPD
• Summa Physicians LLC

  • Psychiatry Physician
  • Akron, OH
  • NPI 1649681917
  NPD

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1811629173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3593 MEDINA RD # 105",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3780 MEDINA RD",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442569311",
            "telephone_number": "330-721-7604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Arch St Ste 410",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443041433",
            "country_code": "US",
            "telephone_number": "330-375-7474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3593 Medina Rd # 105",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "OH",
            "postal_code": "442568182",
            "country_code": "US",
            "telephone_number": "330-635-1272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOWACK",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OH",
            "license": "RN312992",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0031605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern Ohio Medical Specialists, LLC
• Dinah Beth Norton, OTRL
• Jacob Norwillo
• Donna Nottingham
• Keith Novak, M.D.
• NP Medical Solutions LLC
• Tranell Nurse
• Nurturing Hands and Hearts LTD
• Nutrient Rich Life Nutrition Coaching LLC
• Alexandra Rochelle O'Brien, LISW

• Psychiatric/Mental Health Nurse Practitioner in Medina, OH
• Providers in Medina, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.