Christina M Wills, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

3010911 Issued in KY

Practice address

1107 Crown Pointe Dr Ste 107
Elizabethtown, KY 42701-7280

Phone

(270) 506-3300

Fax

(270) 506-2843

NPI assigned

Dec 20, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Christina M Herald Former name

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Concord Company of Tennessee PLLCGroup PAC ID 0345588109, 68 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Owensboro Health Twin Lakes Medical Center Hospital, Leitchfield, KY, CCN 180070

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Concord Company of Tennessee PLLC

  • Emergency Medicine Physician
  • Leitchfield, KY
  • NPI 1649743667
  Medicare reassignment Care Compare group
• Commonwealth Pain Associates, PLLC

  • Interventional Pain Medicine Physician
  • Louisville, KY
  • NPI 1306280177

  Nurse Practitioner

  Medicare reassignment NPD
• Fast Pace Kentucky PLLC

  • Family Nurse Practitioner
  • Franklin, KY
  • NPI 1457716706
  Medicare reassignment NPD
• Floyd Emergency Group, LLC

  • Emergency Medicine Physician
  • Prestonsburg, KY
  • NPI 1760834345

  Nurse Practitioner

  Medicare reassignment NPD
• Concord Medical Group of Kentucky PLLC

  • Emergency Medicine Physician
  • Hardinsburg, KY
  • NPI 1346746385
  Medicare reassignment
• Commonwealth Pain Associates PLLC

  • Durable Medical Equipment & Medical Supplies
  • Paducah, KY
  • NPI 1114753720
  NPD
• Fast Pace Kentucky, PLLC

  • Rural Health Clinic/Center
  • Spindale, NC
  • NPI 1942027891
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Owensboro Health Twin Lakes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Leitchfield, KY
  • NPI 1285221416
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1482192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1003351586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 EXECUTIVE PARK",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074201",
            "telephone_number": "502-907-0356",
            "fax_number": "502-919-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 CROWN POINTE DR STE 107",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427017280",
            "telephone_number": "270-506-3300",
            "fax_number": "270-506-2843"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 Ky Route 321",
            "address_purpose": "LOCATION",
            "city": "Prestonsburg",
            "state": "KY",
            "postal_code": "416539113",
            "country_code": "US",
            "telephone_number": "606-886-8511",
            "fax_number": "606-886-1316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLS",
        "first_name": "CHRISTINA",
        "middle_name": "M",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-20",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3010911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300005142",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100471480",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "HERALD",
            "middle_name": "M",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rebecca Williams, PHARMD
• Rebecca Ruth Williams, O.D.
• Tanya Marie Williams, APRN
• Ted Williams, PT, DPT
• Brad Williamson, TCADC
• Adena Nicole Wilson, APRN
• Afiya Kashawn Wilson, BASW, TCADC
• Amber Rae Wilson, APRN-BC
• Rita Wilson, CSW
• Tasha Wilson

• Nurse Practitioner in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.