Individual provider Active NPI

Kimberly Mund-Wolkenbreit, RN,IBCLC

  • Community Health Registered Nurse
  • Salida, CO
National Provider Identifier
1144743949
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
RN.0124448 Issued in CO
Practice address
448 E 1St St Ste 137
Salida, CO 81201-2804
Phone
(719) 293-1934
NPI assigned
Jul 24, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered NurseGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 163WC1500X RN.0124448 CO Primary

Addresses

Primary practice location

448 E 1St St Ste 137
Salida, CO 81201-2804

Mailing address

448 E 1St St Ste 137
Salida, CO 81201-2804
Phone (970) 409-8884

Other practice location 1

360 Peak One Dr
Frisco, CO 80443-5948
Phone (970) 409-8884

Other identifiers 1

IdentifierTypeStateIssuer
601802330MedicaidCO

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.0124448COMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1144743949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 E 1ST ST STE 137",
            "city": "SALIDA",
            "state": "CO",
            "postal_code": "812012804",
            "telephone_number": "970-409-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 E 1ST ST STE 137",
            "city": "SALIDA",
            "state": "CO",
            "postal_code": "812012804",
            "telephone_number": "719-293-1934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 Peak One Dr",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "CO",
            "postal_code": "804435948",
            "country_code": "US",
            "telephone_number": "970-409-8884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUND-WOLKENBREIT",
        "first_name": "KIMBERLY",
        "credential": "RN,IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-24",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": "CO",
            "license": "RN.0124448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "601802330",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salida, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.