Dr Kimberly M Wilson, NMD,LPC,LMFT, LCDC,L is a medicare enrolled "Naturopath" provider in Phoenix, Arizona. Her current practice location is
2942 N 24th St, #114-545, Phoenix, Arizona. You can reach out to her office (for appointments etc.) via phone at
(888) 539-1233.
Dr Kimberly M Wilson is licensed to practice in Arizona (license number 07-1039) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1235316159.
Healthcare Provider's Profile
| Full Name | Dr Kimberly M Wilson |
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| Gender | Female |
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| Speciality | Naturopath |
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| Location | 2942 N 24th St, Phoenix, Arizona |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1235316159
- Provider Enumeration Date: 01/22/2008
- Last Update Date: 01/09/2024
Medicare PECOS Information:
- PECOS PAC ID: 3375990385
- Enrollment ID: I20240418003479
Medical Identifiers
Medical identifiers for Dr Kimberly M Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1235316159 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 15525 (Texas) | Secondary |
| 101YM0800X | Counselor - Mental Health | 84153 (Texas) | Secondary |
| 106H00000X | Marriage & Family Therapist | 203984 (Texas) | Secondary |
| 133N00000X | Nutritionist | 071039 (Arizona) | Secondary |
| 174H00000X | Health Educator | (* (Not Available)) | Secondary |
| 174N00000X | Lactation Consultant, Non-rn | (* (Not Available)) | Secondary |
| 175L00000X | Homeopath | 071039 (Arizona) | Secondary |
| 176B00000X | Midwife | (* (Not Available)) | Secondary |
| 225700000X | Massage Therapist | MI3923 (Texas) | Secondary |
| 374J00000X | Doula | (* (Not Available)) | Secondary |
| 376K00000X | Nurse's Aide | (Texas) | Secondary |
| 175F00000X | Naturopath | 07-1039 (Arizona) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kimberly M Wilson allows following entities to bill medicare on her behalf.
| Entity Name | Grow Healthcare Group Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1245845932
PECOS PAC ID: 3476961368
Enrollment ID: O20220525002138 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kimberly M Wilson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Kimberly M Wilson, NMD,LPC,LMFT, LCDC,L
712 Mason Dr, Virtual Services Only,
Allen, TX 75013
Ph: (888) 539-1233 | Dr Kimberly M Wilson, NMD,LPC,LMFT, LCDC,L
2942 N 24th St, #114-545,
Phoenix, AZ 85016
Ph: (888) 539-1233 |
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