The Wish Clinic

LBN: Traci A. Kimball Md Pc
The Wish Clinic is an health care organization with primary practice located at 4045 Wadsworth Blvd Ste 10 , Wheat Ridge CO 80033-4625. The organization recently has 13 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Dietary & Nutritional Service Providers / Nutrition, Education, Nursing Service Providers / Case Management, Nursing Service Providers / Infusion Therapy, Nursing Service Providers / Wound Care, Nursing Service Providers / Licensed Practical Nurse, Other Service Providers / Research Study, Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist, Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Surgery, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Clinical Exercise Physiologist, Ambulatory Health Care Facilities / Multi-Specialty. Ambulatory Health Care Facilities / Multi-Specialty is the primary health care specialty. Traci A. Kimball Md Pc can be contacted via phone (303) 940-1611, or through Kimball, Traci A. via phone (720) 557-6510.

Contact Information

Primary practice address
4045 Wadsworth Blvd Ste 10 Wheat Ridge CO 80033-4625
Phone: (303) 940-1611
Fax: (303) 432-2296
Website:
Map and Directions
Authorized official contact:
Name: Kimball, Traci A. Doctor of Medicine (MD)
Phone: (720) 557-6510

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X
Dietary & Nutritional Service Providers / Nutrition, Education 133NN1002X
Nursing Service Providers / Case Management 163WC0400X
Nursing Service Providers / Infusion Therapy 163WI0500X
Nursing Service Providers / Wound Care 163WW0000X
Nursing Service Providers / Licensed Practical Nurse 164W00000X
Other Service Providers / Research Study 1744R1102X
Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X
Allopathic & Osteopathic Physicians / Surgery 208600000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Clinical Exercise Physiologist 224Y00000X
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X

Profile Details

NPI number 1174305601
LBN Legal business name Traci A. Kimball Md Pc
DBA Doing business as The Wish Clinic
Authorized official Kimball, Traci A. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 18th, 2023
Last updated Feb 19th, 2024 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174305601 NPPES
Colorado MEDICAID 9000223352

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