KIMBERLY ANN NOWACK – Psychiatric/Mental Health Nurse Practitioner, NPI 1811629173

KIMBERLY ANN NOWACK is a healthcare provider. based in Akron, Ohio. specializing in NURSE PRACTITIONER. They hold a License No. RN312992 (OH). The NPI Number for KIMBERLY ANN NOWACK is 1811629173

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLY ANN NOWACK
NPI
1811629173
Phone
(330) 375-7474
Address
75 Arch St Ste 410
Enumeration Date
27 June 2022
Last Update Date
1 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2022 (4 years ago)
PAC ID
7810372653
Group Practice PAC ID
2961303532
Professional Enrollment ID
I20220915001297
Address ID
OH443041619AK525XXSTXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:3State licenses:2Digital endpointsOther names

14,984 NURSE PRACTITIONER in OH

Provider Addresses for KIMBERLY ANN NOWACK

  • 75 Arch St Ste 410

    Akron, OH 443041433

    Phone: (330) 375-7474

    Type: Location

  • 3593 Medina Rd # 105

    Medina, OH 442568182

    Phone: (330) 635-1272

    Type: Location

  • 1835 FRANKS PKWY

    UNIONTOWN, OH 446856249

    Phone:

    Type: Mailing

  • 3593 MEDINA RD # 105

    MEDINA, OH 442568182

    Phone:

    Type: Mailing

  • 3780 MEDINA RD

    MEDINA, OH 442569311

    Phone: (330) 721-7604

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-09-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220915001297INurse PractitionerOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44304)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2961303532View full group profile
NameSpecialtyState
Nurse PractitionerGA
-OH
Critical Care (Intensivists)KY
-OH
Family PracticeOH
Family PracticeOH
Cardiovascular Disease (Cardiology)OH
N E P H R O L O G YOH
Nurse PractitionerOH
General SurgeryIL

Reviews

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Frequently asked questions

Is there an official ID for KIMBERLY ANN NOWACK in U.S. healthcare records?
The official identifier for KIMBERLY ANN NOWACK is NPI 1811629173.
Would KIMBERLY ANN NOWACK appear as active to a payer?
You can treat KIMBERLY ANN NOWACK as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with KIMBERLY ANN NOWACK?
KIMBERLY ANN NOWACK's record emphasizes Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with KIMBERLY ANN NOWACK?
Directory geography for KIMBERLY ANN NOWACK centers on Akron, Ohio.
What does 6 location(s) imply?
6 practice locations appear in the available data.

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