KIM WOLLER, RN — NPI 1174929285 (Licensed & Credentialed Registered Nurse in EDGAR, WI)

CMS-1500 Box 24J / 33a • NPI

1174929285

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

163W00000X

Licensed & Credentialed Registered Nurse

Box 32 Service Location & ZIP+4

319 QUAW AVE, EDGAR, WI, 54426-9316

✓ 9-Digit EDI 837 ZIP+4 (54426-9316)

Practice Phone & Referral Fax

(715) 352-3593

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1174929285 (KIM WOLLER, RN) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1174929285` (NPI-1 Individual Practitioner)
Provider / Legal Name	KIM WOLLER, RN
Plain-English Specialty	Licensed & Credentialed Registered Nurse NUCC Code: `163W00000X` (Registered Nurse)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	319 QUAW AVE, EDGAR, WI, 54426-9316
Practice Telephone / Fax	Tel: (715) 352-3593
Administrative Mailing Address	319 QUAW AVE, EDGAR, WI, 54426-9316
Enumeration & Last Sync	Enumerated: 2014-11-17 \| CMS Record Updated: 2015-03-12

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

319 QUAW AVE, EDGAR, WI, 54426-9316

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Plain-English Taxonomy & CMS Crosswalk (163W00000X)

What Does Taxonomy Code 163W00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 163W00000X translates to:
"Licensed & Credentialed Registered Nurse"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Registered Nurse for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (KIM WOLLER, RN)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`164X00000X` — Licensed Vocational Nurse Plain English: Licensed & Credentialed Licensed Vocational Nurse	State: WI \| License: `318084` \| Primary: Secondary
`163W00000X` — Registered Nurse Plain English: Licensed & Credentialed Registered Nurse	State: WI \| License: `221487` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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KIM WOLLER, RN (NPI #1174929285)