Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kimberly Diane Wallingford

Individual provider Physical Therapist · NPI 1104369164

Kimberly Diane Wallingford is a Physical Therapist in Private Practice in Brunswick, Maine. Qualified in 2016, 10 years ago. Practices with Pinnacle Rehabilitation Network LLC, a 105-clinician group and accepts Medicare assignment. Licensed in Maine.

Years since qualifying
10
Licensed in
ME
In the registry since
2016
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Practice location Address checks out

114 Bath Rd Ste 201
Brunswick, ME 04011-2606
Phone: (207) 884-8923
Fax: (207) 884-8972
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT4737 (ME)

Record details

NPI number1104369164
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 23, 2016
Last updated in NPPESAugust 29, 2023
Certification dateAugust 29, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Pinnacle Rehabilitation Network Llc — 105 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Brunswick