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Deactivated NPI 1104992791 Deactivated / Inactive NPI Female Practitioner

Sandra Lou Kimble , CRNP

Nurse Practitioner • Beachwood, OH

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Sandra Kimble has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 27, 2006
NPI Deactivation Date August 03, 2017
Total Practice Duration ~11 Years of Practice (2006 – 2017)

Professional Overview & Biography Verified Profile Summary

Sandra Kimble, CRNP was a registered Nurse Practitioner practicing in Beachwood, OH. Throughout an active medical career spanning 11 years, Sandra Kimble provided care at the practice location at 23210 CHAGIN BLVD until profile deactivation on 2017-08-03.

Practice Location & Contact Primary Location

Practice Address

23210 Chagin Blvd
Suite 400

Beachwood, OH 441225429

Telephone 2168316466
Fax 2167666083
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Beachwood, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 7.8 Yrs
State Avg: 9.8 Yrs
Regional Practice Density
45 Specialists

Practicing in Beachwood, OH (4294 Statewide)

Telehealth Adoption Rate
6.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License OH NP07853

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Danielle Hassell

Licensed Practical Nurse

NPI 1023563806
James Wolen

Social Worker - Clinical

NPI 1043633571
Victoria Tremelin

Case Manager/Care Coordinator

NPI 1053875351
Kathryn Webb , RN

Registered Nurse

NPI 1063871499

Registered Nurse

Daniel Vilamaa

Case Manager/Care Coordinator

NPI 1083277115
Gary Mahoney , RN

Registered Nurse

NPI 1093174856

Registered Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 03, 2017

Record deactivated on August 03, 2017

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 23210 CHAGIN BLVD, SUITE 400, BEACHWOOD, OH 441225429 (Tel: 2168316466)

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Updated Business Mailing Address July 08, 2007

Registered at 23210 CHAGIN BLVD, SUITE 400, BEACHWOOD, OH 441225429 (Tel: 2168316466)

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Provider Name / Credentials Updated July 08, 2007

Recorded as SANDRA KIMBLE, CRNP

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Nurse Practitioner (License #NP07853 in OH)

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Initial NPI Registration & Enumeration November 27, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104992791
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 27, 2006
Last Update: July 08, 2007
Deactivation Date: August 03, 2017

Mailing Address

23210 Chagin Blvd, Suite 400

Beachwood, OH 441225429

Phone: 2168316466

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.