Kieonna Wadlington, AGPCNP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

3014638 Issued in KY

Practice address

650 Joel Dr
Fort Campbell, KY 42223-5318

Phone

(623) 533-1495

NPI assigned

May 29, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KY, TN2 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

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Iris Medical GroupGroup PAC ID 0648653360, 82 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Iris Medical Group

  • Primary Care Clinic/Center
  • Brentwood, TN
  • NPI 1851025902
  Medicare reassignment Care Compare group NPD
• Telos Health Systems Ky LLC

  • Mental Health Counselor
  • Louisville, KY
  • NPI 1629600879
  Medicare reassignment NPD
• Concertocare Medical Group of Tennessee, PC

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1780423863

  KY

  Medicare reassignment NPD
• Iris Wound Care, PC

  • Clinic/Center
  • Brentwood, TN
  • NPI 1568273605
  NPD (past)

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604188800000",
    "number": "1336707959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "623-533-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "623-533-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADLINGTON",
        "first_name": "KIEONNA",
        "name_prefix": "Mrs.",
        "credential": "AGPCNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2020-11-01",
        "certification_date": "2020-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TN",
            "license": "27568",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "225445",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KY",
            "license": "3014638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Vinzant, SLP
• Phillip Volkert, PHYSICIAN ASSISTANT
• Kristin M Volle, DPT
• Jennifer Voorman
• Annette C Wade
• Norman J Waecker Jr., M.D.
• Cynthia K. Waggoner, RN
• Kyle Alexander Wagner, PA-C
• Angela Patricia Walford-Maragh, LCSW
• James H Walker, MD

• Gerontology Nurse Practitioner in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Gerontology Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.