Individual provider Active NPI

Kimberly Wilkins

  • Massage Therapist
  • Baltimore, MD
National Provider Identifier
1912669607
Registry record updated Oct 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
R00697 Issued in MD
Practice address
4408 Mary Ave
Baltimore, MD 21206-2802
Phone
(443) 226-3323
NPI assigned
Oct 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X R00697 MD Primary

Addresses

Primary practice location

4408 Mary Ave
Baltimore, MD 21206-2802

Mailing address

4408 Mary Ave
Baltimore, MD 21206-2802
Phone (443) 226-3323

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

State licenses

LicenseStateTypeSpecialty
R00697MDMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1633824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633824000000",
    "number": "1912669607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4408 MARY AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212062802",
            "telephone_number": "443-226-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4408 MARY AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212062802",
            "telephone_number": "443-226-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-10",
        "last_updated": "2021-10-10",
        "certification_date": "2021-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MD",
            "license": "R00697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2021; 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.