Active NPI
Kimberly Garrett Wilkerson, RD, LD, CDE
- Registered Dietitian
- Fort Collins, CO
National Provider Identifier
1134324619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 3519 Richmond Dr
Fort Collins, CO 80526-5995 - Phone
- (970) 204-0300
- Fax
- (970) 226-9041
- NPI assigned
- Jun 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
3519 Richmond Dr
Fort Collins, CO 80526-5995
Mailing address
3519 Richmond Dr
Fort Collins, CO 80526-5995
Phone (970) 204-0300
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 632685 | Other | ADA REGISTERED DIETITIAN | |
| DT80452 | Other | TX | TEXAS DIETITIAN LICENSE |
| 187347 | Other | CO | CERTIFIED DIABETES EDUCATOR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393545600000",
"number": "1134324619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3519 RICHMOND DR",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805265995",
"telephone_number": "970-204-0300",
"fax_number": "970-226-9041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3519 RICHMOND DR",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805265995",
"telephone_number": "970-204-0300",
"fax_number": "970-226-9041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKERSON",
"first_name": "KIMBERLY",
"middle_name": "GARRETT",
"name_prefix": "Mrs.",
"credential": "RD, LD, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-15",
"last_updated": "2014-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADA REGISTERED DIETITIAN",
"identifier": "632685",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS DIETITIAN LICENSE",
"identifier": "DT80452",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED DIABETES EDUCATOR",
"identifier": "187347",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.