KIMBERLY WELLS MD
NPI 1114372836
Pediatrics - Pediatric Emergency Medicine in Tacoma, WA

Q: What is Kimberly Wells's NPI number?

The NPI number for Kimberly Wells is 1114372836. It was assigned to this individual provider in the NPPES registry on May 2, 2016.

Q: What is Kimberly Wells's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Q: When was this NPI record last updated?

The NPPES record for Kimberly Wells was last updated on March 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.

Active since May 02, 2016PECOS Enrolled

317 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405(253) 403-1418(253) 403-5955 Get Directions Write a Review

NPPES record last updated: March 18, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 18, 2025, Jun 6, 2019 (2 updates tracked since 2019).

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About Kimberly Wells Md NPPES

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

KIMBERLY WELLS MD (NPI 1114372836) is an individual pediatric emergency medicine provider in Tacoma, Washington, licensed in Washington (MD61274189) and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS and maintains a secondary practice location in Syracuse.

NPPES Registry Identity

NPI1114372836

Entity TypeIndividualFemale

Primary Taxonomy2080P0204X

Provider Legal NameKIMBERLY WELLSCredential: MD

Location Address317 MARTIN LUTHER KING JR WAYTacoma, WA 98405-4234

Mailing AddressPo Box 5299, Ms: 820-5-pcoTacoma, WA 98415-0299 · (253) 459-8231

Phone(253) 403-1418

Fax(253) 403-5955

Sole ProprietorNo

Enumeration DateMay 2, 2016

Last NPPES UpdateMarch 18, 20252 updates tracked since enumeration

NPPES CertifiedMarch 18, 2025

✔ NPI 1114372836 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0204X

License✔ Licensed in WA · MD61274189

Definition

A pediatrician who has special qualifications to manage emergencies in infants and children.

Also ListedEmergency Medicine · Pediatric Emergency MedicineTaxonomy 207PP0204X · License 297724 (NY)

317 MARTIN LUTHER KING JR WAY, Tacoma, WA 98405

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Secondary Practice Location 1

Location 1750 E Adams StSyracuse, NY 13210-2306 · Phone (315) 464-5420

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kimberly Wells Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

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

JUYOUNG PARK

Student in an Organized Health Care Education/Training Program