Individual provider Active NPI

Kimberly A. Wolfe, CNP

  • Nurse Practitioner
  • Sterling, IL
National Provider Identifier
1376695122
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209006503 Issued in IL
Practice address
101 E Miller Rd
Sterling, IL 61081-1252
Phone
(815) 625-4790
NPI assigned
Jan 18, 2007
Last updated
Jul 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209006503 IL Primary

Addresses

Primary practice location

101 E Miller Rd
Sterling, IL 61081-1252

Mailing address

101 E Miller Rd
Sterling, IL 61081-1252
Phone (815) 625-4790

Other identifiers 2

IdentifierTypeStateIssuer
P00405463OtherRAILROAD MEDICARE
041310037OtherILRN LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kimberly.wolfe.p1@direct.cghmc.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20070427000045 IL Practitioner - Nurse Practitioner 1557467230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CGH Medical CenterGroup PAC ID 6103723267, 199 clinicians

Practice addresses (Care Compare)

10 W 3Rd St
Sterling, IL 61081-3503
Phone (815) 632-5300

101 E Miller Rd
Sterling, IL 61081-1252
Phone (815) 625-4790

3010 E Lynn Blvd
Sterling, IL 61081-1717
Phone (815) 625-6750

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209006503ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rock River Health, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kwolfe20441@cghmc.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1376695122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MILLER RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811252",
            "telephone_number": "815-625-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MILLER RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811252",
            "telephone_number": "815-625-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "KIMBERLY",
        "middle_name": "A.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209006503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00405463",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "041310037",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kimberly.wolfe.p1@direct.cghmc.nextgenshare.com",
            "affiliation": "N",
            "address_1": "101 E Miller Rd",
            "city": "Sterling",
            "state": "IL",
            "country_code": "US",
            "postal_code": "610811252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sterling, IL

Sources for this page

Verify at the official NPI Registry.