Kimberly M Wilson, MSW,LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C008067 Issued in NC

Practice address

Medical Center Blvd
Winston Salem, NC 27157-0001

Phone

(336) 716-2255

NPI assigned

Oct 2, 2018

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 30, 2023 through Dec 30, 2027

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1508341876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "MSW,LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie L. Wilson, MA,CCC-SLP
• John Allen Wilson Jr., MD
• John McFarland Wilson, M.D.
• John S. Wilson, M.D.
• Kaitlyn Marie Wilson
• Loretta K Wilson, ANP
• McKenzie Laine Wilson, LCSW
• Megan Gauthey Wilson, M.S, CCC/SLP
• Michael Wilson, DPM
• Natasha Ann Wilson

• Clinical Social Worker in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.