Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kimberly Ann Black

Individual provider Family Nurse Practitioner · NPI 1578153953

Kimberly Ann Black is a Nurse Practitioner in Garfield Heights, Ohio. Qualified in 2020, 6 years ago. Practices with Wissam Khoury DPM LLC, a 13-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
6
Licensed in
OH
In the registry since
2021

Practice location Address checks out

10500 Antenucci Blvd
Garfield Heights, OH 44125
Phone: (440) 891-6500
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN.CNP.0028206 (OH)

Record details

NPI number1578153953
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 20, 2021
Last updated in NPPESJanuary 20, 2021
Certification dateJanuary 5, 2021
Mailing address4283 Ridgeland Cir, Cleveland, OH 44135-1000

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Wissam Khoury Dpm Llc — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Garfield Heights