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KIMBERLEY MAE WILSON RDN
NPI 1104579069
Dietitian, Registered in Virginia Beach, VA

Active since February 01, 2022Accepts Medicare Assignment
1933 HAVILAND DR, VIRGINIA BEACH, VA 23454(302) 465-3066 Get Directions Write a Review

NPPES record last updated: August 24, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 24, 2023, Feb 1, 2022 (2 updates tracked since 2022).

About Kimberley Mae Wilson Rdn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLEY MAE WILSON RDN (NPI 1104579069) is an individual dietitian, registered in Virginia Beach, Virginia, licensed in Virginia (86100729) and active in the NPI registry since February 2022. She maintains a secondary practice location in Norfolk and is a graduate of University Of Alabama School Of Medicine (2023).

NPPES Registry Identity

NPI1104579069
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameKIMBERLEY MAE WILSONCredential: RDN
Location Address1933 HAVILAND DRVirginia Beach, VA 23454-6704
Mailing Address1933 Haviland DrVirginia Beach, VA 23454-6704 · (302) 465-3066
Phone(302) 465-3066
Sole ProprietorYes
Medical School CMSUniversity Of Alabama School Of MedicineGraduated 2023
Enumeration DateFebruary 1, 2022
Last NPPES UpdateAugust 24, 20232 updates tracked since enumeration
NPPES CertifiedAugust 24, 2023
✔ NPI 1104579069 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in VA · 86100729
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
Also ListedNutritionistTaxonomy 133N00000X · License 86100729 (VA)
Also ListedNutritionist · Nutrition, EducationTaxonomy 133NN1002X · License 86100729 (VA)
1933 HAVILAND DR, Virginia Beach, VA 23454
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Secondary Practice Location 1

Location 16333 Center Dr Bldg 16Norfolk, VA 23502-4126 · Phone (757) 252-9500

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kimberley Mae Wilson Rdn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133575129
PECOS Enrollment IDI20231027000347

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23454 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $56.19 – $170.30
Typical copayment $0.00 (range $14.04 – $42.57)
Most-billed visit code NA
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELEANOR ERIKSON HEAD
Specialist/Technologist (Athletic Trainer)
1933 HAVILAND DR
VIRGINIA BEACH, VA 23454
Virginia Beach City (847) 508-2245

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberley Wilson's NPI number?

The NPI number for Kimberley Wilson is 1104579069. It was assigned to this individual provider in the NPPES registry on February 1, 2022.

Where is Kimberley Wilson located?

Kimberley Wilson practices at 1933 Haviland Dr, Virginia Beach, VA 23454. The listed phone number is (302) 465-3066.

What is Kimberley Wilson's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Kimberley Wilson enrolled in Medicare?

Yes. Kimberley Wilson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kimberley Wilson was last updated on August 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.