Kim Marie Wolf, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

966-033 Issued in WI

Practice address

13800 W Maria Dr
New Berlin, WI 53151-6889

Phone

(414) 529-4378

NPI assigned

Jun 20, 2008

Last updated

Dec 31, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in WI

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 1

Specialty

Nurse Practitioner

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Horizon Healthcare, IncGroup PAC ID 0749182160, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Horizon Healthcare, Inc

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1225052830

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Granada Psychiatry L L C

  • Psychiatry Physician
  • Canton, MI
  • NPI 1619728615

  WI

  Medicare reassignment NPD
• Horizon Healthcare, Inc

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1639193212
  NPD
• Visiting MD LTD

  • General Practice Physician
  • Waukesha, WI
  • NPI 1366724478
  NPD (past)
• Wauwatosa Pain Management , LLC

  • Pain Clinic/Center
  • Wauwatosa, WI
  • NPI 1649511304
  NPD (past)

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546214400000",
    "number": "1366603581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13800 W MARIA DR",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531516889",
            "telephone_number": "414-630-7156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 W MARIA DR",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531516889",
            "telephone_number": "414-529-4378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "KIM",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2018-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "966-033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366603581",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wisconsin Dental Group, S.C. (ForwardDental New Berlin)
• Wisconsin Vision, LLC (Heartland Vision)
• Mary Kae Wisinski, P.T.
• Joan Susan Wojtal, SLP
• Michele Wolaver, MA, CCC-SLP
• Lauren Nicole Wren, APNP
• Larry David Wruck, D.D.S.
• Bao Xiong-Mdshahrin, DNP, APNP, FNP-BC
• Yackels Eyecare, LLC
• Christine Mierha Yang, R.PH

• Nurse Practitioner in New Berlin, WI
• Providers in New Berlin, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2018; 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.