Individual provider Active NPI

Wendy Kimmelman, CNM

  • Advanced Practice Midwife
  • Albuquerque, NM
National Provider Identifier
1003849662
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
11577 Issued in NM
Practice address
201 Cedar St SE Ste 5600
Albuquerque, NM 87106-4920
Phone
(505) 563-6000
Fax
(505) 727-9590
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 11577 NM Primary
Midwife 176B00000X 519 NM

Addresses

Primary practice location

201 Cedar St SE Ste 5600
Albuquerque, NM 87106-4920

Mailing address

PO Box 26666
Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-6770

Other practice location 1

1001 Coal Ave SE
Albuquerque, NM 87106-5205
Phone (505) 843-6168 ext. 3005

Other identifiers 1

IdentifierTypeStateIssuer
28982339MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041227000017 NM Practitioner - Certified Nurse Midwife (CNM) 8426016353 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

201 Cedar St SE
Suite 5600
Albuquerque, NM 87106-4920
Phone (505) 563-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
519NMMDClinical Psychologist
11577NMMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Aug 11, 2019 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Aug 11, 2019 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

10511 Golf Course Rd NW
Ste 201
Albuquerque, NM 87114
Phone (505) 232-1180

4705 Montgomery Blvd NE
Ste 301
Albuquerque, NM 87109
Phone (505) 727-4500

8080 Academy Rd NE
Albuquerque, NM 87111
Phone (505) 727-3400

Interoperability endpoints

  • Direct secure messaging: wkimmelman152733@direct.phs.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1003849662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CEDAR ST SE STE 5600",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064920",
            "telephone_number": "505-563-6000",
            "fax_number": "505-727-9590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Coal Ave SE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871065205",
            "country_code": "US",
            "telephone_number": "505-843-6168 x3005",
            "fax_number": "505-792-1978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMMELMAN",
        "first_name": "WENDY",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NM",
            "license": "11577",
            "primary": true
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NM",
            "license": "519",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28982339",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.