MISS KIMBERLY KAY WALLER-BROWN D.D.S.
NPI 1477623007
Dentist - General Practice in Bluefield, WV

Q: What is Kimberly Waller-brown's NPI number?

The NPI number for Kimberly Waller-brown is 1477623007. It was assigned to this individual provider in the NPPES registry on November 9, 2006.

Q: What is Kimberly Waller-brown's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: Is Kimberly Waller-brown enrolled in Medicare?

No. Kimberly Waller-brown has opted out of Medicare through April 16, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Active since November 09, 2006Opted out of Medicare · through Apr 16, 2027

1609 MARYLAND AVE, BLUEFIELD, WV 24701(304) 327-5506(304) 324-8703 Get Directions Write a Review

NPPES record last updated: May 15, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Miss Kimberly Kay Waller-brown D.d.s. NPPES

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

MISS KIMBERLY KAY WALLER-BROWN D.D.S. (NPI 1477623007) is an individual general practice provider in Bluefield, West Virginia, licensed in West Virginia (3587) and active in the NPI registry since November 2006. She has opted out of Medicare through April 16, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1477623007

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameMISS KIMBERLY KAY WALLER-BROWNCredential: D.D.S.

Location Address1609 MARYLAND AVEBluefield, WV 24701-3803

Mailing Address1609 Maryland AveBluefield, WV 24701-3803 · (304) 327-5506 · Fax (304) 327-5506

Phone(304) 327-5506

Fax(304) 324-8703

Sole ProprietorNo

Enumeration DateNovember 9, 2006

Last NPPES UpdateMay 15, 2015

✔ NPI 1477623007 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in WV · 3587

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

1609 MARYLAND AVE, Bluefield, WV 24701

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Other Identifiers 1

Medicaid3810000311WV

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Miss Kimberly Kay Waller-brown D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 16, 2015 through April 16, 2027.

Opt-Out Effective DateApril 16, 2015

Opt-Out In Effect ThroughApril 16, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 24701 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

$83.49 typical visit price

range $53.20 – $164.59

Typical copayment $20.87 (range $13.30 – $41.14)

Most-billed visit code 99203

Established Patient

$66.84 typical visit price

range $16.47 – $133.29

Typical copayment $16.71 (range $4.11 – $33.32)

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

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

THOMAS L CONKLIN DDS INC

Dentist

1609 MARYLAND AVE
BLUEFIELD, WV 24701

Mercer County (304) 327-5506

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 Kimberly Waller-brown's NPI number?

The NPI number for Kimberly Waller-brown is 1477623007. It was assigned to this individual provider in the NPPES registry on November 9, 2006.

Where is Kimberly Waller-brown located?

Kimberly Waller-brown practices at 1609 Maryland Ave, Bluefield, WV 24701. The listed phone number is (304) 327-5506.

What is Kimberly Waller-brown's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Kimberly Waller-brown enrolled in Medicare?

No. Kimberly Waller-brown has opted out of Medicare through April 16, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Kimberly Waller-brown was last updated on May 15, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.