Kim Matthews Wiggins

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7238226 Issued in TN

Practice address

2584 Faxon Ave
Memphis, TN 38112-2238

Phone

(901) 378-3293

Fax

(901) 343-9311

NPI assigned

Jul 18, 2013

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

• Mrs. Kim Wiggins Professional name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 25, 2022.

{
    "created_epoch": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1942642020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2584 FAXON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381122238",
            "telephone_number": "901-378-3293",
            "fax_number": "901-343-9311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2584 FAXON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381122238",
            "telephone_number": "901-378-3293",
            "fax_number": "901-343-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "KIM",
        "middle_name": "MATTHEWS",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-18",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "332",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "7238226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q071980",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "WIGGINS",
            "prefix": "MRS.",
            "credential": "SLP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Matthew Wideman, MD
• Zachary Robert Wier, DPT
• Kelli Nicole Wierzbicki
• Angel Wiggins
• David Wiles Wiggins, DMD
• Nathan Michael Wiginton, FNP
• Mary Leann Wigley, NP
• Christopher Cory Wilbanks, DNP, APRN, FNP, CNL
• Monica Gomez Wilbekin, PA-C
• Junitha Cannon Wilbert

• All providers in Memphis, TN
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.