KIMBERLY WETHERHOLT CRNA
NPI 1376744268
Nurse Anesthetist, Certified Registered in Harbor City, CA

Q: What is Kimberly Wetherholt's NPI number?

The NPI number for Kimberly Wetherholt is 1376744268. It was assigned to this individual provider in the NPPES registry on May 30, 2007.

Q: What is Kimberly Wetherholt's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Active since May 30, 2007Accepts Medicare Assignment

25825 VERMONT AVE, HARBOR CITY, CA 90710(310) 325-5111 Get Directions Write a Review

NPPES record last updated: November 29, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Kimberly Wetherholt Crna NPPES

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

KIMBERLY WETHERHOLT CRNA (NPI 1376744268) is an individual nurse anesthetist, certified registered in Harbor City, California, licensed in California (NA2413) and active in the NPI registry since May 2007. She is a graduate of Other (1996).

NPPES Registry Identity

NPI1376744268

Entity TypeIndividualFemale

Primary Taxonomy367500000X

Provider Legal NameKIMBERLY WETHERHOLTCredential: CRNA

Location Address25825 VERMONT AVEHarbor City, CA 90710-3518

Mailing Address25825 Vermont AveHarbor City, CA 90710-3518 · (310) 325-5111

Phone(310) 325-5111

Sole ProprietorNo

Medical School CMSOtherGraduated 1996

Enumeration DateMay 30, 2007

Last NPPES UpdateNovember 29, 2021

✔ NPI 1376744268 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in CA · NA2413

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

25825 VERMONT AVE, Harbor City, CA 90710

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kimberly Wetherholt Crna 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 ID9739121997

PECOS Enrollment IDI20050526001040

Medicare Billing Reassignments

Medicare enrollment records show Kimberly Wetherholt reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Southern California Permanente Medical Group

Same address

Health Maintenance Organization

25825 VERMONT AVE
Harbor City, CA 90710

Reassigned Medicare billing, California enrollment
13,921 clinicians in this Medicare group

NPI 1598797011 (310) 325-5111

Om P. Chaurasia, MD, Inc.

40 mi

Gastroenterology

26421 CROWN VALLEY PKWY, SUITE 140A
Mission Viejo, CA 92691

Reassigned Medicare billing, California enrollment
16 clinicians in this Medicare group

NPI 1932232576 (949) 365-8836

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90710 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

$142.39 typical visit price

range $62.96 – $187.60

Typical copayment $35.59 (range $15.74 – $46.90)

Most-billed visit code 99204

Established Patient

$77.96 typical visit price

range $20.84 – $153.61

Typical copayment $19.49 (range $5.21 – $38.40)

Most-billed visit code 99213

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 20

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

SEAN KOH PHARM.D.

Pharmacist