MEDICARE: KIMBERLY ANN CINGLE MD

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	35-07-5779	OH

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	5683020001	OTHER	OH	D M E R C /MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	800519742051	OTHER	OH	CARE SOURCE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	000000374414	OTHER	OH	UNICARE
6	000000656336	OTHER	OH	ANTHEM BLUECROSS

NPI Number	:	1275567885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY ANN CINGLE MD

Provider Business Mailing Address
First Line	:	2013 STATE ROUTE 59
Second Line	:
City	:	KENT
State	:	OH
Zip	:	44240-4113
Country	:	US
Telephone Number	:	330-678-0201
Fax Number	:	330-678-4272

Provider Business Practice Location Address
First Line	:	2013 STATE ROUTE 59
Second Line	:
City	:	KENT
State	:	OH
Zip	:	44240-4113
Country	:	US
Telephone Number	:	330-678-0201
Fax Number	:	330-678-4272

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	12/31/2013

8200 DODGE STREET , CHILDREN'S HOSPITAL & MEDICARE CENTER
OMAHA, NE
68114-4113

Practice Phone: 402-955-6140
Practice Fax: 402-955-3398