Kimberly Ann Woudenberg, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

125081488 Issued in IL

Practice address

301 N 8TH St Ste 3A158
Springfield, IL 62701-1085

Phone

(217) 545-8853

NPI assigned

May 30, 2023

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

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

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": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1669165254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N 8TH ST STE 3A158",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011085",
            "telephone_number": "217-545-8853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N 8TH ST STE 3A158",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011085",
            "telephone_number": "217-545-8853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOUDENBERG",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-30",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125081488",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125081488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marian K. Worthy, APN
• Dawn Wortley, PTA
• Sarah Wortman, CRNA
• Jacobo Wortsman, MD
• Christopher E. Wottowa, M.D.
• Wright Counseling LLC
• Abby Lynne Wright, AU.D.
• Ashlee D. Wright, DNP
• Chelsea Wright
• Elaine E Wright, LCSW

• Psychiatry Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.