Individual provider Active NPI

Kimberly Lynn Wilms, D.P.M.

  • Podiatrist
  • Longmont, CO
National Provider Identifier
1134306475
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
673 Issued in CO
Practice address
1138 Olympia Avenue
Unit B
Longmont, CO 80504
Phone
(419) 788-2396
NPI assigned
Jan 29, 2008
Last updated
May 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 673 CO Primary

Addresses

Primary practice location

1138 Olympia Avenue
Unit B
Longmont, CO 80504

Mailing address

1138 Olympia Avenue
Unit B
Longmont, CO 80504
Phone (419) 788-2396

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110720000152 CO Practitioner - Podiatry 0749458610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.82 of 100Reported as group
Quality
72.99
Improvement activities
40
Cost
75.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
673COMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Wound Care and Healing PC CurrentSince Sep 15, 2025 Accepting new patients
Preferred Podiatry Group PC Podiatrist CurrentSince Feb 1, 2022 Accepting new patients
Altitude Foot & Ankle Center Past Accepting new patients

Locations

1801 California St
Ste 2400
Denver, CO 80202
Phone (720) 912-2423

1330 Sidney Ave
Sterling, CO 80751
Phone (970) 522-4888

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1134306475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 OLYMPIA AVENUE",
            "address_2": "UNIT B",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "80504",
            "telephone_number": "419-788-2396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 OLYMPIA AVENUE",
            "address_2": "UNIT B",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "80504",
            "telephone_number": "419-788-2396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILMS",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-29",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CO",
            "license": "673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.