KIMBERLY MICHELLE WETHERELL — NPI 1720926587 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Long-term Care in ARCADE, NY)

CMS-1500 Box 24J / 33a • NPI

1720926587

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

364SL0600X (CMS 89)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Long-term Care

Box 32 Service Location & ZIP+4

1179 GENESEE RD, ARCADE, NY, 14009-9712

✓ 9-Digit EDI 837 ZIP+4 (14009-9712)

Practice Phone & Referral Fax

(407) 431-5876

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1720926587 (KIMBERLY MICHELLE WETHERELL) 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	`1720926587` (NPI-1 Individual Practitioner)
Provider / Legal Name	KIMBERLY MICHELLE WETHERELL
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Long-term Care NUCC Code: `364SL0600X` (Clinical Nurse Specialist, Long-Term Care)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1179 GENESEE RD, ARCADE, NY, 14009-9712
Practice Telephone / Fax	Tel: (407) 431-5876
Administrative Mailing Address	1179 GENESEE RD, ARCADE, NY, 14009-9712
Enumeration & Last Sync	Enumerated: 2026-03-23 \| CMS Record Updated: 2026-03-23

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1179 GENESEE RD, ARCADE, NY, 14009-9712

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Plain-English Taxonomy & CMS Crosswalk (364SL0600X)

What Does Taxonomy Code 364SL0600X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 364SL0600X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Long-term Care"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 89 (Certified Clinical Nurse Specialist)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Clinical Nurse Specialist, Long-Term Care for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (KIMBERLY MICHELLE WETHERELL)

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
`364SL0600X` — Clinical Nurse Specialist, Long-Term Care Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Long-term Care	State: NY \| License: `NYFL04588320R` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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KIMBERLY MICHELLE WETHERELL (NPI #1720926587)