Individual provider Active NPI

Kimberly Wallerius, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1881006492
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0040895 Issued in OH
Practice address
721 Miami Chapel Rd
Dayton, OH 45417-4650
Phone
(937) 281-6800
NPI assigned
May 30, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0040895 OH Primary

Addresses

Primary practice location

721 Miami Chapel Rd
Dayton, OH 45417-4650

Mailing address

721 Miami Chapel Rd
Dayton, OH 45417-4650
Phone (937) 281-6800

Other names 1

  • Kimberly Bower Former name

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
I20260310001861 OH Practitioner - Nurse Practitioner 3779066600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

721 Miami Chapel Rd
Dayton, OH 45417-4650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0040895OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Five Rivers Health Centers CurrentSince Feb 12, 2026 Accepting new patients
Five Rivers Health Centers CurrentSince Feb 12, 2026 Accepting new patients

Locations

2261 Philadelphia Dr
Dayton, OH 45406
Phone (937) 281-6800

721 Miami Chapel Rd
Dayton, OH 45417
Phone (937) 281-5970

Organizations & group practices 3

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": "1401408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1881006492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 MIAMI CHAPEL RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454174650",
            "telephone_number": "937-281-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 MIAMI CHAPEL RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454174650",
            "telephone_number": "937-281-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLERIUS",
        "first_name": "KIMBERLY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-30",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0040895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "BOWER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.