Kimberly Michelle Wilson, L.M.P. AND L.A.C.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC60241994 Issued in WA

Practice address

1800 Cooks Hill Rd
Suite a
Centralia, WA 98531

Phone

(360) 736-2853

Fax

(360) 736-4159

NPI assigned

Dec 8, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Kimberly Michelle Nelson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Medical Massage Inc

  • Massage Therapist
  • Centralia, WA
  • NPI 1902115371
  NPD (past) Authorized official

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1932269313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COOKS HILL RD",
            "address_2": "SUITE A",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "98531",
            "telephone_number": "360-736-2853",
            "fax_number": "360-736-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 COOKS HILL RD",
            "address_2": "SUITE A",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "98531",
            "telephone_number": "360-736-2853",
            "fax_number": "360-736-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KIMBERLY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "L.M.P. AND L.A.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA13686",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC60241994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "NELSON",
            "middle_name": "MICHELLE",
            "prefix": "MS.",
            "credential": "LMP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wilson & Wilson, DDS PLLC
• Barry K Wilson, M.D.
• Christian Patrick Wilson, D.D.S.
• Courtney Paige Wilson
• Jessica Kay Wilson, HM61029496
• Michelle Bergmann Wilson, DDS
• Paula Wilson
• Rebekah Ruby Lin Wilson
• Robert Wilson, AAC
• Justin Wimpress

• Acupuncturist in Centralia, WA
• Providers in Centralia, WA by specialty
• Acupuncturist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; 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.