Kimberly M Shroyer – Family Nurse Practitioner

Key facts

NPI: 1962087304
Entity type: Individual (NPI type 1)
Primary specialty: Family Nurse Practitioner 363LF0000X
License: APRN.CNP.0028530 (OH)
Practice address: 305 Christie Ave
Anna, OH 45302-8614
Phone: (937) 489-3748
NPI assigned: Mar 17, 2021
Sex: Female
Sole proprietor: Yes

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 and National Provider Directory roles.

Upper Valley Professional Corporation Family Medicine Physician · Troy, OH · NPI 1407872518

Medicare reassignment NPD OH

Medicare participation

Medicare fee-for-service enrollment: Enrolled in OH
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20210609002811	OH	Practitioner - Nurse Practitioner	9234539446	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
Upper Valley Professional Corporation		Current since Jun 21, 2021	Accepting new patients

Locations

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

1752 W High St
Piqua, OH 45356
Phone (513) 773-3737

450 N Hyatt St
Ste 202
Tipp City, OH 45371
Phone (937) 667-3141

Interoperability endpoints

Direct secure messaging: kimberly.shroyer.1@17374.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Nurse Practitioner	363LF0000X	APRN.CNP.0028530	OH	Yes

Addresses

Primary practice location

305 Christie Ave
Anna, OH 45302-8614

Mailing address

3170 Kettering Blvd
Building B 3Rd Floor
Moraine, OH 45439-1924
Phone (937) 991-3188

Other providers in Anna, OH

Revive and Thrive Integrative Medicine LLC
Jaclyn Sue Schmiesing
Lexi Ann Schmiesing
Andrew M Schulze, PT
Riley J Schumpert, FNP-C
Erica Lynn Smith, NP-C
Lena Louise Springer, BCLMT
Abigail Marie Stroh
Gabraiel Arturo Trevino, LAT
Matthew S Vasko, MD

All providers in Anna, OH · Family Nurse Practitioner in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.