Kimberly Shawn Wilkerson, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3011318 Issued in KY

Practice address

1530 Lone Oak Rd
Paducah, KY 42003-7901

Phone

(270) 444-2444

NPI assigned

Mar 25, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DRX - East Missouri Providers PCGroup PAC ID 8921294257, 5 clinicians

Total Access Urgent Care PCGroup PAC ID 8820171929, 130 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• DRX - East Missouri Providers, P.C.

  • Urgent Care Clinic/Center
  • Cape Girardeau, MO
  • NPI 1477867844
  Medicare reassignment Care Compare group NPD
• Total Access Urgent Care, PC

  • Urgent Care Clinic/Center
  • Saint Louis, MO
  • NPI 1962684886
  Medicare reassignment Care Compare group NPD
• Mercy Hospital Springfield

  • General Acute Care Hospital
  • Springfield, MO
  • NPI 1043242159
  Medicare reassignment NPD
• Sikeston Emergency Group LLC

  • Emergency Medicine Physician
  • Sikeston, MO
  • NPI 1427575299
  Medicare reassignment NPD
• Southeastern Emergency Physicians of Memphis LLC

  • Emergency Medicine Physician
  • Alton, IL
  • NPI 1437105277

  MO

  Medicare reassignment NPD
• Southeastern Emergency Services of Memphis, P.C.

  • Emergency Medicine Physician
  • Chattanooga, TN
  • NPI 1164454450

  MO

  Medicare reassignment NPD
• Mercy Hospital Springfield

  • Medicare Defined Swing Bed Hospital Unit
  • Springfield, MO
  • NPI 1053907113
  NPD
• Total Access Urgent Care, PC

  • Urgent Care Clinic/Center
  • Saint Louis, MO
  • NPI 1952729402
  NPD

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

{
    "created_epoch": "1490400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1437680907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SAINT FRANCIS DR",
            "address_2": "ATTN MEDICAL AFFAIRS",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035049",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 LONE OAK RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037901",
            "telephone_number": "270-444-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "KIMBERLY",
        "middle_name": "SHAWN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-25",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017001832",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3011318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "K239330",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100464430",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morgan Wiggins
• Sharon Wilcox, APRN
• Cari B Wildharber, APRN, NP-C
• Mindy L Wilham
• Jonathan David Wilkerson, M.D.
• Lisa Ann Wilkerson
• Regina Dawn Wilkerson, APRN
• Amy Marie Wilkins
• James R Wilkinson, MD
• Nicholas Will

• Family Nurse Practitioner in Paducah, KY
• Providers in Paducah, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.