Individual provider Active NPI

Forreline Grigsby Wilson, FNP-C

  • Family Nurse Practitioner
  • Burbank, CA
National Provider Identifier
1053841759
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95006243 Issued in CA
Practice address
511 N Hollywood Way
Burbank, CA 91505-3406
Phone
(866) 389-2727
NPI assigned
Jun 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95006243 CA Primary

Addresses

Primary practice location

511 N Hollywood Way
Burbank, CA 91505-3406

Mailing address

511 N Hollywood Way
Burbank, CA 91505-3406
Phone (866) 389-2727

Other practice location 1

29610 Rancho California Rd
Temecula, CA 92591-5283
Phone (866) 389-2727

Other practice location 2

1401 S Baldwin Ave
Arcadia, CA 91007-7922
Phone (866) 389-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170721002559 CA Practitioner - Nurse Practitioner 3476823535 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
76.8 of 100Reported as group
Quality
65.04
Improvement activities
40
Cost
86.74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic Medical Group of San Diego Inc Family CurrentSince Mar 31, 2024 Accepting new patients
Minuteclinic Diagnostic Medical Group of California Inc Family CurrentSince Jun 21, 2017 Accepting new patients
Minuteclinic Diagnostic Medical Group of Orange County Inc Family CurrentSince Mar 31, 2024 Accepting new patients

Locations

1401 S Baldwin Ave
Arcadia, CA 91007
Phone (626) 321-4210

511 N Hollywood Way
Burbank, CA 91505
Phone (818) 841-0710

2760 Fletcher Pkwy
El Cajon, CA 92020
Phone 6194614411 ext. 8221

7096 N West Ave
Fresno, CA 93711
Phone (559) 436-0471

11428 Kenyon Way
Rancho Cucamonga, CA 91701
Phone (909) 589-4098

2505 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 828-6456

921 Pacific Coast Hwy
Seal Beach, CA 90740
Phone (562) 598-0473

33205 US Highway 79
Temecula, CA 92592
Phone (951) 303-3154

29610 Rancho California Rd
Temecula, CA 92591
Phone (951) 699-0192

2791 Agoura Rd
Westlake Village, CA 91361
Phone 8054954938 ext. 8221

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1053841759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 N HOLLYWOOD WAY",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915053406",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 N HOLLYWOOD WAY",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915053406",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29610 Rancho California Rd",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925915283",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1401 S Baldwin Ave",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "CA",
            "postal_code": "910077922",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "FORRELINE",
        "middle_name": "GRIGSBY",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.