Kimberly Diane Wallingford

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT4737 Issued in ME

Practice address

114 Bath Rd Ste 201
Brunswick, ME 04011-2606

Phone

(207) 884-8923

Fax

(207) 884-8972

NPI assigned

Nov 23, 2016

Last updated

Aug 29, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Wallingford Macvane Former name

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinnacle Rehabilitation Network LLCGroup PAC ID 7618872086, 105 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Pinnacle Rehabilitation Network, LLC

  dba Advanced Physical Therapy

  • Physical Therapist
  • Scarborough, ME
  • NPI 1437247095
  Medicare reassignment Care Compare group NPD
• Pinnacle Rehabilitation Network LLC

  dba Waypoint Physical Therapy

  • Physical Therapist
  • Freeport, ME
  • NPI 1235940388
  NPD
• Pinnacle Rehabilitation Network LLC

  dba Accel Physical Therapy

  • Physical Therapist
  • Brunswick, ME
  • NPI 1710412705
  NPD
• Alliance Physical Therapy, LLC

  • Physical Therapist
  • Portland, ME
  • NPI 1902274541
  NPD (past)
• Pinnacle Rehabilitation Network LLC

  dba Alliance Physical Therapy

  • Physical Therapist
  • Portland, ME
  • NPI 1043688039
  NPD (past)

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

{
    "created_epoch": "1479859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1104369164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 NEWTON RD",
            "address_2": "STE 101",
            "city": "PLAISTOW",
            "state": "NH",
            "postal_code": "038652424",
            "telephone_number": "978-388-7272",
            "fax_number": "978-388-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 BATH RD STE 201",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112606",
            "telephone_number": "207-884-8923",
            "fax_number": "207-884-8972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLINGFORD",
        "first_name": "KIMBERLY",
        "middle_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-23",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT4737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MACVANE",
            "middle_name": "WALLINGFORD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wal-Mart Stores East, LP (Vision Center 30-1939)
• Kenneth Walden, LCPC
• Walgreen Eastern Co Inc (Walgreens #17725)
• Elizabeth T Wall, D.O.
• Alexis G Waller, MS, MDIV, THD, LCPCC
• David Wallstrom, PA-C
• Laura Walsh, CRNA
• Michaela Walsh, PHD
• Melissa A Walters, PA-C
• Julia B Waltman, LCPC-C

• Physical Therapist in Brunswick, ME
• Providers in Brunswick, ME by specialty
• Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.