Kimberly White (NPI# 1679522965, PAC ID# 0749188332) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OBSTETRICS/GYNECOLOGY.
| Nation Provider ID (NPI) | 1679522965 |
| PAC ID by PECOS | 0749188332 |
| Professional Enrollment ID | I20100208000569 |
| Full Name | Kimberly White |
| Organization Legal Name | REVITALIZE MEDICAL GROUP LTD |
| Address |
935 Trailwood Dr A Youngstown OH 44512-5062 |
| Phone Number | 8558298315 |
| Gender | F |
| Medical School | UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE |
| Graduation Year | 1987 |
| Primary Specialty | OBSTETRICS/GYNECOLOGY |
| Group Practice PAC ID | 4981845831 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 360020 | SUMMA HEALTH SYSTEM |
| 360027 | AKRON GENERAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 525 E Market St, Akron, OH 44304-1619 | SUMMA PHYSICIANS INC | |
| 935 Trailwood Dr A, Youngstown, OH 44512-5062 | 8558298315 | REVITALIZE MEDICAL GROUP LTD |
| Organization Legal Name | REVITALIZE MEDICAL GROUP LTD |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Victoria L Shaw | Nurse Practitioner | Revitalize Medical Group Ltd | 51 Park W Blvd, Suite 100, Akron, OH 44320-4215 |
| Tara D Scott | Obstetrics/gynecology | Revitalize Medical Group Ltd | 935 Trailwood Dr A, Youngstown, OH 44512-5062 |
| Carmencita B Slabinski | Internal Medicine | Revitalize Medical Group Ltd | 51 Park W Blvd, Suite 100, Akron, OH 44320-4215 |
| Street Address |
935 TRAILWOOD DR A |
| City | YOUNGSTOWN |
| State | OH |
| Zip | 44512-5062 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anthony P Koulianos | Obstetrics/gynecology | 935 Trailwood Dr A, Youngstown, OH 44512-5062 | |
| Tara D Scott | Obstetrics/gynecology | Revitalize Medical Group Ltd | 935 Trailwood Dr A, Youngstown, OH 44512-5062 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Deborah Louise Sano | Psychologist, Clinical | 7010 S Ave, Suite 5, Boardman, OH 44512 | |
| Charles E Wilkins | Geriatric Medicine | 4214 Market St, Youngstown, OH 44512-1118 | |
| Louis Michael Chiaro | Podiatry | 156 Overhill Rd, Boardman, OH 44512-1455 | |
| Tony T Deramo | Allergy/immunology | 5701 Market St, Youngstown, OH 44512-2603 | |
| Carl Franklin Ansevin | Neurology | 5701 Market St, Suite 101, Boardman, OH 44512-2603 | |
| Mary Newell Waller | Psychologist, Clinical | 5500 Market St, Suite 90, Youngstown, OH 44512-2616 | |
| Katharine Williams | Psychologist, Clinical | 5500 Market St, Suite 205, Boardman, OH 44512-2624 | |
| Patrick R Ranalli | Physical Therapy | 5500 Market St, Suite 127, Youngstown, OH 44512-2625 | |
| Christine L Fullerman | Audiologist | Youngstown Hearing and Speech Center | 6614 Southern Blvd, Youngstown, OH 44512-3455 |
| Andrew J Meyer | Anesthesiology | Children's Hospital Medical Center of Akron | 6505 Market St, Boardman, OH 44512-3457 |
| Find all physicians in zip 44512 | |||
| City | YOUNGSTOWN |
| Zip Code | 44512 |
| Specialty | OBSTETRICS/GYNECOLOGY |
| City + Specialty | YOUNGSTOWN + OBSTETRICS/GYNECOLOGY |
Please comment or provide details below to improve the information on Kimberly White.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.