Individual provider Active NPI

Kimberly Angela Tanner, FNP

  • Family Nurse Practitioner
  • Strongsville, OH
National Provider Identifier
1922649235
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.025188 Issued in OH
Practice address
18181 Pearl Rd Ste B202
Strongsville, OH 44136-6951
Phone
(440) 816-4900
NPI assigned
Oct 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.025188 OH Primary

Addresses

Primary practice location

18181 Pearl Rd Ste B202
Strongsville, OH 44136-6951

Mailing address

15818 Albion Rd
Strongsville, OH 44136-3653
Phone (440) 465-3595

Other names 1

  • Kimberly Angela McDaniel Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ktanner@direct.swgeneral.com Southwest General Medical Group, Inc.

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
I20200124001348 OH Practitioner - Nurse Practitioner 1759716525 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

18181 Pearl Rd
B202
Strongsville, OH 44136-6951
Phone (440) 816-4965

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest General Medical Group, Inc. CurrentSince Dec 16, 2019 Accepting new patients
Southwest General Medical Group Inc Current Accepting new patients
Southwest General Medical Group Inc CurrentSince Dec 16, 2019 Accepting new patients
Southwest General Health Center CurrentSince Jun 21, 2024 Accepting new patients

Locations

7255 Old Oak Blvd
Ste C202
Middleburg Heights, OH 44130
Phone (440) 816-5390

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

18181 Pearl Rd
Ste B202
Strongsville, OH 44136
Phone (440) 816-4960

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1922649235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15818 ALBION RD",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441363653",
            "telephone_number": "440-465-3595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18181 PEARL RD STE B202",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441366951",
            "telephone_number": "440-816-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "KIMBERLY",
        "middle_name": "ANGELA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.025188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ktanner@direct.swgeneral.com",
            "affiliation": "Y",
            "affiliationName": "Southwest General Medical Group, Inc.",
            "address_1": "18181 Pearl Rd Ste B202",
            "city": "Strongsville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441366951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MCDANIEL",
            "middle_name": "ANGELA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Strongsville, OH

Sources for this page

Verify at the official NPI Registry.