Individual provider Active NPI

Kimberly Ione Wageley, WHNP/CNM

  • Advanced Practice Midwife
  • Albuquerque, NM
National Provider Identifier
1912725300
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
887 Issued in NM
Practice address
1100 Central Ave SE
Albuquerque, NM 87106-4934
Phone
(505) 907-8375
NPI assigned
Oct 2, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 887 NM Primary

Addresses

Primary practice location

1100 Central Ave SE
Albuquerque, NM 87106-4934

Mailing address

9505 Thunder Rd NW
Albuquerque, NM 87120-4233
Phone (505) 907-8375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241018001667 NM Practitioner - Certified Nurse Midwife (CNM) 3971035627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

201 Cedar St SE
Suite 5600
Albuquerque, NM 87106-4920
Phone (505) 563-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
887NMMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Nov 19, 2024 Accepting new patients
Presbyterian Healthcare Services CurrentSince Nov 19, 2024 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

3630 Las Estancias Dr SW
Albuquerque, NM 87121
Phone (505) 462-7777

201 Cedar St SE
Ste 5600
Albuquerque, NM 87106
Phone (505) 554-7836

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

1100 Central Ave SE
Ste 5600
Albuquerque, NM 87106
Phone (505) 841-0922

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

2400 Unser Blvd SE
Rio Rancho, NM 87124
Phone (505) 253-0000

Interoperability endpoints

  • Direct secure messaging: kwageley259388@direct.phs.org

Organizations & group practices 3

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1912725300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9505 THUNDER RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871204233",
            "telephone_number": "505-907-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064934",
            "telephone_number": "505-907-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGELEY",
        "first_name": "KIMBERLY",
        "middle_name": "IONE",
        "credential": "WHNP/CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NM",
            "license": "887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.