Individual provider Active NPI

Kimberly Carlene Letson, APRN

  • Acute Care Nurse Practitioner
  • Fairlawn, OH
National Provider Identifier
1902462054
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN.CNP.024571 Issued in OH
Practice address
3562 Ridge Park Dr Ste D1
Fairlawn, OH 44333-9294
Phone
(330) 664-1670
NPI assigned
May 14, 2019
Last updated
Aug 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X RN.313361 OH
Physical Medicine & Rehabilitation Physician 208100000X APRN.CNP.024571 OH
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.024571 OH Primary

Addresses

Primary practice location

3562 Ridge Park Dr Ste D1
Fairlawn, OH 44333-9294

Mailing address

4387 Leewood Rd
Stow, OH 44224-2520
Phone (330) 807-5421

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
I20230925001179 OH Practitioner - Nurse Practitioner 3375946684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio Healthcare Partners LLCGroup PAC ID 5890095293, 2 clinicians

Practice addresses (Care Compare)

3562 Ridge Park Dr
Suite D1
Fairlawn, OH 44333-9294
Phone (330) 664-1670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.024571OHMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Healthcare Partners, LLC CurrentSince Aug 14, 2023 Accepting new patients

Locations

3562 Ridge Park Dr
Unit D1
Fairlawn, OH 44333

3562 Ridge Park Dr
Ste D1
Fairlawn, OH 44333
Phone (330) 664-1670

3562 Ridge Park Dr
Ste D
Fairlawn, OH 44333

Interoperability endpoints

  • Direct secure messaging: kimberlyletson@cps.directglo.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1902462054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4387 LEEWOOD RD",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442242520",
            "telephone_number": "330-807-5421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3562 RIDGE PARK DR STE D1",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443339294",
            "telephone_number": "330-664-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETSON",
        "first_name": "KIMBERLY",
        "middle_name": "CARLENE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-14",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "OH",
            "license": "RN.313361",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "APRN.CNP.024571",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.024571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

Verify at the official NPI Registry.