Kimberly Moore Wesley, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

304185 Issued in NY

Practice address

2 Coulter Rd
Clifton Springs, NY 14432-1122

Phone

(585) 922-1900

Fax

(585) 922-1002

NPI assigned

Jun 12, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Ann Moore II Former name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1144262379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 COULTER RD",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "144321122",
            "telephone_number": "315-462-9478",
            "fax_number": "315-462-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COULTER RD",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "144321122",
            "telephone_number": "585-922-1900",
            "fax_number": "585-922-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESLEY",
        "first_name": "KIMBERLY",
        "middle_name": "MOORE",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "304185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MOORE",
            "middle_name": "ANN",
            "suffix": "II",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathleen Mattoon Vanderbrook, N.P.
• Shelby Vanderbrook, LAC
• Samantha Hope Vitale, MSW
• Amanda Walters, LMT
• Wayne-Clifton Pharmacy Inc.
• J Diane West, MD
• Gabrielle Westbrook
• Jaime Leigh Westbrook, AUD
• Western New York Medical Practice P.C
• Western New York Medical Practice PC

• Adult Health Nurse Practitioner in Clifton Springs, NY
• Providers in Clifton Springs, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.