Active NPI
Kimberly Wells, R.N.
- Addiction (Substance Use Disorder) Registered Nurse
- Newaygo, MI
National Provider Identifier
1699123471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Registered Nurse
- License
- 4704210008
- Practice address
- 519 E Brook Dr
Newaygo, MI 49337-8573 - Phone
- (231) 250-4073
- NPI assigned
- Jun 2, 2016
- Last updated
- Jun 2, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Registered Nurse | 163WA0400X | 4704210008 | MI | Primary |
Addresses
Primary practice location
519 E Brook Dr
Newaygo, MI 49337-8573
Mailing address
519 E Brook Dr
Newaygo, MI 49337-8573
Phone (231) 250-4073
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704210008 | MI | MD | Addiction (Substance Use Disorder) Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464825600000",
"number": "1699123471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "519 E BROOK DR",
"city": "NEWAYGO",
"state": "MI",
"postal_code": "493378573",
"telephone_number": "231-250-4073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "519 E BROOK DR",
"city": "NEWAYGO",
"state": "MI",
"postal_code": "493378573",
"telephone_number": "231-250-4073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "KIMBERLY",
"credential": "R.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-02",
"last_updated": "2016-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "163WA0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Addiction (Substance Use Disorder)",
"state": "MI",
"license": "4704210008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newaygo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.