Kimberly Wood, CPC - INTERN

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CI661 Issued in NV

Practice address

2921 N Tenaya Way
Las Vegas, NV 89128-1409

Phone

(702) 942-1774

NPI assigned

Jun 24, 2019

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

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Legacy Health and Wellness, LLC

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1457600645
  Medicare reassignment NPD
• Legacy Health and Wellness, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Las Vegas, NV
  • NPI 1003507500
  NPD

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1447811120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 N TENAYA WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281409",
            "telephone_number": "928-486-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 N TENAYA WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281409",
            "telephone_number": "702-942-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "KIMBERLY",
        "credential": "CPC - INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "CI661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Elaine Wood
• Jennifer Wood, FNP-C
• Jeremy Wayne Wood, D.P.M.
• Joshua Cory Wood, DPT
• Kelly Ann Wood
• Kristin Wood
• Kylie Wood
• Maria Wood
• Marie Elain Wood
• Marin Wood, PAC

• Mental Health Counselor in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Mental Health Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.