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

Mrs. Kimberly Mattson Wieringa, PA-C

Individual provider Physician Assistant · NPI 1316136591

Mrs. Kimberly Mattson Wieringa, PA-C is a Physician Assistant in Jacksonville, Florida. Qualified in 2010, 16 years ago. Practices with Florida Rehab Specialists, PLLC, a 80-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
16
Licensed in
FL
In the registry since
2007
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone: (904) 953-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1633 Race Track Rd, Jacksonville, FL 32259-3234 — (904) 451-0587

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9105525 (FL)

Record details

NPI number1316136591
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 23, 2007
Last updated in NPPESFebruary 9, 2024
Certification dateFebruary 9, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Florida Rehab Specialists, Pllc — 80 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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