KIMBERLY ANNE WILMOTH (NPI# 1679019020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1679019020 |
Entity Type | Individual |
Full Name | KIMBERLY ANNE WILMOTH |
Credential | APRN, FNP-C |
Practice Address |
1336 Highway 54 W Fayetteville GA 30214-4535 |
Practice Telephone | 7704611238 |
Mailing Telephone | 7704611238 |
Enumeration Date | 2017-01-10 |
Last Update Date | 2017-06-02 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN122557 | GA | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 003187048B | 05 | |
GA | 003187048A | 05 |
Street Address |
1336 HIGHWAY 54 W |
City | FAYETTEVILLE |
State | GA |
Zip Code | 30214-4535 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891795407 | Tara Beth Gochenour | Specialist/Technologist | 1336 Highway 54 W, Bldg 500, Fayetteville, GA 30214-4535 | 2005-07-26 |
1538523964 | Christopher Bryan Bush | Nurse Practitioner | 1336 Highway 54 W, Bldg. 500, Fayetteville, GA 30214-4535 | 2016-04-12 |
1457630659 | Laura H Taylor | Specialist/Technologist | 1336 Highway 54 W, Bldg 500, Fayetteville, GA 30214-4535 | 2011-08-05 |
1407090459 | Edan Shapiro | Urology | 1336 Highway 54 W, Bldg 200, Fayetteville, GA 30214-4535 | 2009-04-21 |
1245473990 | Hagop Sarkissian | Urology | 1336 Highway 54 W, Bldg 200, Fayetteville, GA 30214-4535 | 2009-04-10 |
1124295357 | Amita Agarwal | Occupational Therapist | 1336 Highway 54 W, Fayetteville, GA 30214-4535 | 2008-05-16 |
1861679805 | John Thomas Abbott Jr. | Urology | 1336 Highway 54 W, Bldg 200, Fayetteville, GA 30214-4535 | 2008-01-22 |
1942426168 | Georgia Urology Pa | Urology | 1336 Highway 54 W, Building 200, Fayetteville, GA 30214-4535 | 2007-04-17 |
1649307885 | Resurgens, PC | Orthopaedic Surgery | 1336 Highway 54 W, Building 500, Fayetteville, GA 30214-4549 | 2007-02-27 |
1053414458 | Scott W Shelfo | Urology | 1336 Highway 54 W, Bldg 200, Fayetteville, GA 30214-4535 | 2006-09-07 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
Find all providers in zip 30214 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528674181 | Maggie Mullican | Nurse Practitioner | 7084 S Pleasant Ridge Dr, Fayetteville, AR 72704-5447 | 2020-09-18 |
1720690167 | Stephen Arthur Lepak | Nurse Practitioner | 6871 Appleton Dr, Fayetteville, PA 17222-9383 | 2020-08-18 |
1750990255 | Towauna Daya | Nurse Practitioner | 1338 Redwine Rd, Fayetteville, GA 30215-2509 | 2020-07-30 |
1316555642 | Constance Ofundem Takang | Nurse Practitioner | 110 Emerald Lake Ct, Fayetteville, GA 30215-7747 | 2020-07-22 |
1851916472 | Breanna Mills | Nurse Practitioner | 2623 N Fire Fly Catch Dr, Fayetteville, AR 72704-6313 | 2020-06-09 |
1922621069 | Laura Sarai Perez | Nurse Practitioner | 480 Lees Lake Rd, Fayetteville, GA 30214-3106 | 2020-05-23 |
1902431125 | Crystal Baker English | Nurse Practitioner | 113 Old Bethel Rd, Fayetteville, TN 37334-6186 | 2020-03-09 |
1568092708 | Stephanie Elizabeth Fields | Nurse Practitioner | 1265 Highway 54 Ste 402, Fayetteville, GA 30214-4537 | 2020-01-15 |
1437616364 | Andrea Teal Bergman | Nurse Practitioner | Physicians Medical Walk In Care, 2893 Huntsville Hwy, Fayetteville, TN 37334-6729 | 2019-02-27 |
1639634447 | Arica Adams-gro'ce | Nurse Practitioner | 4028 Lifestyle Rd, Fayetteville, NC 28312-9335 | 2019-02-06 |
Find all providers in FAYETTEVILLE |
City | FAYETTEVILLE |
Zip Code | 30214 |
Please comment or provide details below to improve the information on KIMBERLY ANNE WILMOTH.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.