Active NPI
Stormi Wilson
- Registered Nurse
- Florence, SC
National Provider Identifier
1053089557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 201176
- Practice address
- 125 E Cheves St
Florence, SC 29506-2526 - Phone
- (843) 317-4073
- Fax
- (843) 317-4096
- NPI assigned
- Aug 31, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 201176 | SC | Primary |
Addresses
Primary practice location
125 E Cheves St
Florence, SC 29506-2526
Mailing address
125 E Cheves St
Florence, SC 29506-2526
Phone (843) 317-4073
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201176 | SC | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630368000000",
"number": "1053089557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 E CHEVES ST",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295062526",
"telephone_number": "843-317-4073",
"fax_number": "843-317-4096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 E CHEVES ST",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295062526",
"telephone_number": "843-317-4073",
"fax_number": "843-317-4096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "STORMI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-31",
"last_updated": "2021-08-31",
"certification_date": "2021-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "SC",
"license": "201176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florence, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.