KIM L WILDE (NPI# 1891744140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891744140 |
| Entity Type | Individual |
| Full Name | KIM L WILDE |
| Credential | MD |
| Practice Address |
1001 E Superior St Ste L401 Duluth MN 55802 |
| Mailing Address |
1001 E Superior St Ste L401 Duluth MN 55802-2207 |
| Practice Telephone | 2182497960 |
| Practice Fax Number | 2182497997 |
| Mailing Telephone | 2182497960 |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2019-09-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 65959 | MN | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 2534 | SD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 6000743 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1001 E Superior St Ste L401, Duluth, MN 558022207 | 2182497960 | 2182497997 |
| 506 1st Ave Se, Watertown, SD 572014402 | 6058868482 | 6058844300 |
| Street Address |
1001 E SUPERIOR ST STE L401 |
| City | DULUTH |
| State | MN |
| Zip Code | 55802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265078968 | Jennifer Lynn Nelson | Nurse Practitioner | 1001 E Superior St Ste L401, Duluth, MN 55802-2207 | 2019-11-18 |
| 1629624531 | Sakina Zaheer | Pharmacist | 1001 E Superior St Ste L401, Duluth, MN 55802-2207 | 2019-08-15 |
| 1063992535 | Stephanie Rae Harnack | Nurse Practitioner | 1001 E Superior St Ste L401, Duluth, MN 55802-2207 | 2018-08-15 |
| 1437679859 | Courtney F Murphy-bakken | Pharmacist | 1001 E Superior St Ste L401, Duluth, MN 55802-2207 | 2017-06-27 |
| 1467803031 | Nicole Marie Wilke | Nurse Practitioner | 1001 E Superior St Ste L401, Duluth, MN 55802 | 2016-06-24 |
| 1548623085 | Kristina Kay Anderson | Internal Medicine | 1001 E Superior St Ste L401, Duluth, MN 55802 | 2016-04-01 |
| 1700243243 | Anna Rosenberg | Nurse Practitioner | 1001 E Superior St Ste L401, Duluth, MN 55802-2207 | 2016-01-27 |
| 1700261427 | Jessica Gerard | Nurse Practitioner | 1001 E Superior St Ste L401, Duluth, MN 55802-2207 | 2015-07-23 |
| 1457739179 | Mark Wiita | Nurse Practitioner | 1001 E Superior St Ste L401, Duluth, MN 55802-2207 | 2015-05-14 |
| 1144617283 | Steven James Finstad | Internal Medicine | 1001 E Superior St Ste L401, Duluth, MN 55802 | 2015-04-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063915239 | Jpw Counseling & Consultation | Social Worker | 302 W Superior St Ste 508, Duluth, MN 55802 | 2018-03-14 |
| 1134664311 | Amp Group, LLC | Counselor | 331 West Superior Street, Duluth, MN 55802 | 2016-12-27 |
| 1982151361 | Tiffany Riester | Counselor | 332 W Superior Street, Suite 300, Duluth, MN 55802 | 2016-09-02 |
| 1730635392 | Karina Krosbakken | Counselor | 332 W. Superior St., Suite 300, Duluth, MN 55802 | 2016-09-01 |
| 1437559051 | Natalie R Zwak | Dietitian, Registered | 26 E Superior St Ste 315, Duluth, MN 55802 | 2014-09-02 |
| 1447679279 | Valerie Lou Shelton | Registered Nurse | 118 E Superior St., Duluth, MN 55802 | 2014-04-09 |
| 1285063115 | Brian Bergstedt | Counselor | 332 West Superior Street, Suite 300, Duluth, MN 55802 | 2013-11-01 |
| 1508135948 | Karen Dee Turner | Counselor | 202 W. Superior Street, Suite 700, Duluth, MN 55802 | 2011-12-14 |
| 1497023410 | Jean Barrie Mcbride | Pharmacist | 1131 East Superior Street, Duluth, MN 55802 | 2011-12-05 |
| 1194092304 | Diane Murphy Winship | Pharmacist | 1331 Superior St, Duluth, MN 55802 | 2011-11-17 |
| Find all providers in zip 55802 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427664333 | Nations Medical Clinic Inc | Internal Medicine | 3099 Bredkinridge Blvd, Suite 110/111, Duluth, GA 30096-1011 | 2020-09-17 |
| 1659986057 | Herman Medical Solutions, LLC | Internal Medicine | 10700 Medlock Bridge Road, Suite 207, Duluth, GA 30097 | 2020-09-11 |
| 1891193082 | Connie Hall Shrake | Internal Medicine | 3380 Moye Trl, Duluth, GA 30097-3780 | 2014-12-20 |
| 1336546662 | Robert Derro | Internal Medicine | 3662 Howell Wood Trl, Duluth, GA 30096-4803 | 2014-12-02 |
| 1992137962 | Nandi Md Incorporated | Internal Medicine | 8510 Prairie Dunes Way, Duluth, GA 30097-6666 | 2013-08-01 |
| 1730317827 | Swapna Devanna | Internal Medicine | 1001 E Superior St Ste L101, Duluth, MN 55802 | 2009-06-26 |
| 1699933226 | Shreya Raja | Internal Medicine | 5355 Northwater Way, Duluth, GA 30097-6424 | 2008-05-30 |
| 1306028410 | Christina H. Bastin Dejong | Internal Medicine | 400 E. 3rd St., Duluth Clinic, Duluth, MN 55805 | 2007-11-30 |
| 1588798706 | Susanne Pearce | Internal Medicine | 324 W. Superior St, Suite 625, Duluth, MN 55802 | 2007-03-16 |
| 1629122684 | Priority Primary Care | Internal Medicine | 3540 Duluth Park Ln Ste 170, Duluth, GA 30096-8721 | 2007-01-23 |
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| 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.