Kimberly Drew Wingler, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

227022381 Issued in IL

Practice address

2046 Jonathan Creek Rd
Arthur, IL 61911-6108

Phone

(217) 962-0614

NPI assigned

Nov 8, 2021

Last updated

Nov 8, 2021By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Willow Tree Wellness Center LLC

  • Health Service Clinic/Center
  • Arthur, IL
  • NPI 1316717523
  NPD

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1194480889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2046 JONATHAN CREEK RD",
            "city": "ARTHUR",
            "state": "IL",
            "postal_code": "619116108",
            "telephone_number": "217-962-0614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2046 JONATHAN CREEK RD",
            "city": "ARTHUR",
            "state": "IL",
            "postal_code": "619116108",
            "telephone_number": "217-962-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINGLER",
        "first_name": "KIMBERLY",
        "middle_name": "DREW",
        "name_prefix": "Miss",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227022381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "willowtreewellnesscenter@yahoo.com",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "2046 Jonathan Creek Rd",
            "city": "Arthur",
            "state": "IL",
            "country_code": "US",
            "postal_code": "619116108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jameia C Tyler, CF, MA
• William H Shackelford MD
• Willow Tree Wellness Center LLC
• Dolores Josephine Wilson, APRN, FNP-C
• James E Winfield, DMD

• Massage Therapist in Arthur, IL
• Providers in Arthur, IL by specialty
• Massage Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.