KIMBERLY CAROL VANDALEN
NPI 1053784009
Nurse Practitioner - Family in Xenia, OH

Active since November 12, 2015PECOS Enrolled
193 S PROGRESS DR, XENIA, OH 45385(937) 372-7583 Get Directions Write a Review

NPPES record last updated: October 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 22, 2020, Nov 12, 2015 (2 updates tracked since 2015).

About Kimberly Carol Vandalen NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY CAROL VANDALEN (NPI 1053784009) is an individual family provider in Xenia, Ohio, licensed in Ohio (APRN.CNP.025839) and active in the NPI registry since November 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053784009
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKIMBERLY CAROL VANDALEN
Location Address193 S PROGRESS DRXenia, OH 45385-2673
Mailing Address193 S Progress DrXenia, OH 45385-2673 · (937) 372-7583
Sole ProprietorNo
Enumeration DateNovember 12, 2015
Last NPPES UpdateOctober 22, 20202 updates tracked since enumeration
NPPES CertifiedOctober 22, 2020
NPI 1053784009 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses Licensed in OH · APRN.CNP.025839 Licensed in TX · AP129610
Also ListedFamily MedicineTaxonomy 207Q00000X · License AP129610 (TX)
Also ListedPreventive Medicine · Public Health & General Preventive MedicineTaxonomy 2083P0901X · License AP129610 (TX)
Also ListedGeneral PracticeTaxonomy 208D00000X · License AP129610 (TX)
193 S PROGRESS DR, Xenia, OH 45385

Other Identifiers 7

Other87V600TX · Bcbs
OtherAP129610TX · Texas State License
Medicaid063389301TX
Medicaid083850001TX
Medicaid0389946OH
Medicaid017801401TX
Other87V601TX · Bcbs

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Kimberly Carol Vandalen is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45385 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
193 S PROGRESS DR
XENIA, OH 45385

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Vandalen's NPI number?

The NPI number for Kimberly Vandalen is 1053784009. It was assigned to this individual provider in the NPPES registry on November 12, 2015.

Where is Kimberly Vandalen located?

Kimberly Vandalen practices at 193 S Progress Dr, Xenia, OH 45385. The listed phone number is (937) 372-7583.

What is Kimberly Vandalen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kimberly Vandalen enrolled in Medicare?

Yes. Kimberly Vandalen is registered in the Medicare PECOS enrollment system.

What insurance does Kimberly Vandalen accept?

Health plans from CareSource list Kimberly Vandalen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kimberly Vandalen was last updated on October 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.