Kim Wilder-Dyer, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

026957 Issued in GA

Practice address

700 Church St NE
Marietta, GA 30060-7220

Phone

(770) 420-1600

Fax

(770) 420-1612

NPI assigned

Oct 27, 2005

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1629068945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHURCH ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607220",
            "telephone_number": "770-420-1600",
            "fax_number": "770-420-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHURCH ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607220",
            "telephone_number": "770-420-1600",
            "fax_number": "770-420-1612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1810 White Cir Ste 120",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300665836",
            "country_code": "US",
            "telephone_number": "770-420-1600",
            "fax_number": "770-420-1612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILDER-DYER",
        "first_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "026957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwilderdyer7495@directwellstar.org",
            "affiliation": "N",
            "address_1": "1810 White Cir Ste 120",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300665836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Caroline Wiggins, PTA
• Kenneth Morris Wiggins Jr., D.D.S.
• Charles Wike, M.D.
• Miriam Hope Whatley Wilcox, M.C.D., CCC-A
• Wildbrook Psychiatry, LLC
• Marina Shikhris Wilder, MD
• Walter B Wildstein, M.D.
• Wildwood Eye Care LLC
• Brian Joseph Wilehlm, CNIM
• Gennifer N. Wiley, MD

• Internal Medicine Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.