Kimberly Wahl

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN208988 Issued in GA

Practice address

200 S Houston Lake Rd
Warner Robins, GA 31088-9006

Phone

(478) 953-6727

NPI assigned

Jun 12, 2015

Last updated

Jun 12, 2015By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Georgia Em-I Medical Services. LLC

  • Nurse Practitioner
  • Bremen, GA
  • NPI 1851569560
  Medicare reassignment NPD
• Houston County Emergency Group, LLC

  • Emergency Medicine Physician
  • Warner Robins, GA
  • NPI 1013338193
  Medicare reassignment NPD
• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment NPD
• FL-I Medical Services, LLC

  • Nurse Practitioner
  • Fort Pierce, FL
  • NPI 1750655106
  Medicare reassignment NPD
• Floridian Emergency Specialists LLC

  • Emergency Medicine Physician
  • Melbourne, FL
  • NPI 1710210695
  Medicare reassignment NPD
• Hospital Medicine Services of FL, LLC

  • Hospitalist Physician
  • Aventura, FL
  • NPI 1710684857
  Medicare reassignment NPD
• Pensacola Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Pensacola, FL
  • NPI 1801841473
  Medicare reassignment NPD
• Georgia Em-I Medical Services PC

  • Emergency Medicine Physician
  • Covington, GA
  • NPI 1780080192

  Nurse Practitioner

  NPD
• Georgia Em-I Medical Services, LLC

  • Nurse Practitioner
  • Covington, GA
  • NPI 1255213005
  NPD
• Houston County Emergency Group, LLC

  • Emergency Medicine Physician
  • Perry, GA
  • NPI 1467873547
  NPD
• FL-I Medical Services LLC

  • Physician Assistant
  • Haines City, FL
  • NPI 1285356790

  Nurse Practitioner

  NPD
• FL-I Medical Services LLC

  • Emergency Medicine Physician
  • Destin, FL
  • NPI 1659720654

  Nurse Practitioner

  NPD

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434067200000",
    "number": "1700267994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S HOUSTON LAKE RD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310889006",
            "telephone_number": "478-955-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S HOUSTON LAKE RD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310889006",
            "telephone_number": "478-953-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHL",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2015-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN208988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATION NUMBER (AMERICAN ACADEMY NURSE PRACTITIONERS)",
            "identifier": "F0515490",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA STATE NURSE PRACTITIONER LICENSURE",
            "identifier": "RN208988",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• W. Steven Wilson, M.D., P.C.
• Richard Wayne Waddell, D.D.S
• Makayla Lynsey Wade, M.ED CCC-SLP
• Tanviben Wadiwala
• Kristin Ann Jessop Wagner, PSY.D
• Natalie L. Wakeley
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3750)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0920)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1367)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0840)

• Nurse Practitioner in Warner Robins, GA
• Providers in Warner Robins, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; 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.