Kim M Weber, ARNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP144615 Issued in TX

Practice address

5575 Warren Pkwy Ste 115
Frisco, TX 75034-4063

Phone

(903) 251-9851

Fax

(903) 865-5722

NPI assigned

May 8, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kim M Mikulencak Other name

Medicare fee-for-service enrollment

Enrolled in TX, OK2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: premierhealthcare.kimweber@157137.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Premier Healthcare Specialists

  • Nurse Practitioner
  • McKinney, TX
  • NPI 1114705308
  Medicare reassignment NPD Authorized official
• Total Wound Care of Texas LLC

  • Internal Medicine Physician
  • McKinney, TX
  • NPI 1225741937
  Medicare reassignment NPD
• Total Wound Care of Oklahoma, LLC

  • Internal Medicine Physician
  • Oklahoma City, OK
  • NPI 1972269033
  Medicare reassignment NPD

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

{
    "created_epoch": "1588896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1174145494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 N EAST ST # 270",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750904724",
            "telephone_number": "903-251-9851",
            "fax_number": "903-865-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 WARREN PKWY STE 115",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750344063",
            "telephone_number": "903-251-9851",
            "fax_number": "903-865-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "KIM",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-08",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP144615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "MIKULENCAK",
            "middle_name": "M",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alven Terrell Weathersby, LPC
• Maria-Raquel Weaver, M.D.
• Stewart Ry Weaver, D.C.
• Kyle Webb
• Joli Webberman
• Robin Ann Weerts, CRNA
• Brian Lynn Weger, P.T.
• Ryan Joseph Weiche
• Lisa E Weil
• Jonathan Robert Weinstein, M.D.

• Gerontology Nurse Practitioner in Frisco, TX
• Providers in Frisco, TX by specialty
• Gerontology Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.