NPIMap

Organization Active NPI

Kimberly S Adams PSYD PC

  • Clinical Neuropsychologist
  • Wilmington, NC
National Provider Identifier
1629258801
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
KIMBERLY S ADAMS PSYD PC
Practice address
710 Military Cutoff Rd
Suite 120
Wilmington, NC 28405-2375
Phone
(910) 254-4818
Fax
(910) 254-4819
NPI assigned
Nov 6, 2007
Last updated
Jul 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

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

Authorized official

Name
Dr. Kimberly S Adams, PSY.D.NPI 1093875338
Title
President
Phone
(910) 254-4818

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X NU Primary
Clinical Psychologist 103TC0700X NU

Addresses

Primary practice location

710 Military Cutoff Rd
Suite 120
Wilmington, NC 28405-2375

Mailing address

710 Military Cutoff Rd
Suite 120
Wilmington, NC 28405-2375
Phone (910) 254-4818

Other identifiers 1

IdentifierTypeStateIssuer
6001005MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280275200000",
    "number": "1629258801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 MILITARY CUTOFF RD",
            "address_2": "SUITE 120",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284052375",
            "telephone_number": "910-254-4818",
            "fax_number": "910-254-4819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 MILITARY CUTOFF RD",
            "address_2": "SUITE 120",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284052375",
            "telephone_number": "910-254-4818",
            "fax_number": "910-254-4819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY S ADAMS PSYD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-06",
        "last_updated": "2010-07-28",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-254-4818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6001005",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; 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.