Kim I Wolter, MSN, RN, CHPN, PHN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

201704864RN Issued in OR

Practice address

615 5TH St
Brookings, OR 97415-9199

Phone

(541) 813-2535

NPI assigned

Sep 21, 2017

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Registered Nurse

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 and National Provider Directory roles.

• Curry Community Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gold Beach, OR
  • NPI 1629322847
  NPD (past)
• Freedom Healthcare Inc

  • Mental Health Counselor
  • Eugene, OR
  • NPI 1225638067
  NPD (past)

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505952000000",
    "number": "1306355367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "city": "GOLD BEACH",
            "state": "OR",
            "postal_code": "974440810",
            "telephone_number": "541-813-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 5TH ST",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974159199",
            "telephone_number": "541-813-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLTER",
        "first_name": "KIM",
        "middle_name": "I",
        "credential": "MSN, RN, CHPN, PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-21",
        "last_updated": "2017-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201704864RN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "201704864RN",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald B Williams, RPH
• Krista Nichole Wilson
• Melissa Louise Wilson, FAMILY NURSE PRACTIT
• Jackie Wiseman
• Nancy Wolf, FNP
• Barbara Lynn Woodcock, P.T.A.
• Lacy Ann Woods, OTR/L
• Laura E Worman, PT
• Michael Worthey, PT
• Timothy L Yantis, PHARMACIST

• Registered Nurse in Brookings, OR
• Providers in Brookings, OR by specialty
• Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2017; 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.