Kimberlynn Wicks

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1717 W Cowles St
Fairbanks, AK 99701-5926

Phone

(907) 452-8251

NPI assigned

Jul 24, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Tanana Chiefs Conference

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1821201278
  NPD (past)

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

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1184032906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 1ST AVE",
            "address_2": "SUITE 300",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014848",
            "telephone_number": "907-452-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015926",
            "telephone_number": "907-452-8251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKS",
        "first_name": "KIMBERLYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-24",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Ann Whitlock
• Cean Whitmarsh, LMT
• Herbert Whitted
• Mishaela Siree Whittier, D.O.
• Jasmine Rose Bullock Wicks, CD(DONA)
• Jonathan Widman
• Megan Wiegand, PHARMD
• Shannon Wiegand, MD
• Jennifer Kay Wieland
• Seth Walter Wietgrefe

• Community Health Worker in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Community Health Worker in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; 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.