Active NPI
Kristin Wimp, D.C.
- Chiropractor
- Santa Monica, CA
National Provider Identifier
1215468889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 33812
- Practice address
- 2915 Santa Monica Blvd
Suite 2
Santa Monica, CA 90404-2438 - Phone
- (310) 998-5800
- Fax
- (310) 998-5811
- NPI assigned
- Mar 24, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 33812 | CA | Primary |
Addresses
Primary practice location
2915 Santa Monica Blvd
Suite 2
Santa Monica, CA 90404-2438
Mailing address
2301 W la Habra Blvd
Apt. 66
La Habra, CA 90631-5071
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210106000644 | FL | Practitioner - Chiropractic | 2567730047 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coquina Sport & Spine, LLC | Chiropractor | Current | Accepting new patients |
Locations
2820 US Highway 1 S
Ste B
Saint Augustine, FL 32086
Phone (904) 484-8685
Organizations & group practices 1
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.
-
- Chiropractor
- St Augustine, FL
- NPI 1720659154
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490313600000",
"number": "1215468889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 W LA HABRA BLVD",
"address_2": "APT. 66",
"city": "LA HABRA",
"state": "CA",
"postal_code": "906315071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2915 SANTA MONICA BLVD",
"address_2": "SUITE 2",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904042438",
"telephone_number": "310-998-5800",
"fax_number": "310-998-5811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIMP",
"first_name": "KRISTIN",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-03-24",
"last_updated": "2017-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "33812",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.