Active NPI
Kenny Wayne Wiggins, LMFT
- Marriage & Family Therapist
- Fort Moore, GA
National Provider Identifier
1144495912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT 00931
- Practice address
- 7970 Martin Loop BLDG 9204
Fort Moore, GA 31905-5623 - Phone
- (706) 545-9449
- NPI assigned
- Apr 23, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFT 00931 | GA | Primary |
Addresses
Primary practice location
7970 Martin Loop BLDG 9204
Fort Moore, GA 31905-5623
Mailing address
1006 Denham Dr
Americus, GA 31709-4312
Phone (229) 942-7785
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT 00931 | GA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695340800000",
"number": "1144495912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1006 DENHAM DR",
"city": "AMERICUS",
"state": "GA",
"postal_code": "317094312",
"telephone_number": "229-942-7785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7970 MARTIN LOOP BLDG 9204",
"city": "FORT MOORE",
"state": "GA",
"postal_code": "319055623",
"telephone_number": "706-545-9449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIGGINS",
"first_name": "KENNY",
"middle_name": "WAYNE",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-23",
"last_updated": "2023-09-22",
"certification_date": "2023-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "GA",
"license": "MFT 00931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Moore, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.