Mary S Wilson, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN-1997 Issued in HI

Practice address

92-8691 Lotus Blossom Lane 6&7
92-8691 Lotus Blossom Lane 6&7
Ocean View, HI 96737-9673

Phone

(808) 939-8100

Fax

(808) 829-3672

NPI assigned

Jul 18, 2006

Last updated

Feb 21, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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

• MCV Associated Physicians

  dba MCV Physicians

  • Anesthesiology Physician
  • Richmond, VA
  • NPI 1710959457
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1073531687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6065",
            "city": "OCEAN VIEW",
            "state": "HI",
            "postal_code": "967376065",
            "telephone_number": "808-939-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92-8691 LOTUS BLOSSOM LANE 6&7",
            "address_2": "92-8691 LOTUS BLOSSOM LANE 6&7",
            "city": "OCEAN VIEW",
            "state": "HI",
            "postal_code": "967379673",
            "telephone_number": "808-939-8100",
            "fax_number": "808-829-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARY",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "HI",
            "license": "APRN-1997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073531687",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10106478",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Leigh Sorenson
• Kathryn Summers
• Jade Thomas, LMT
• VFL Medical
• West Hawaii Community Health Center, Inc. (Hawaii Island Community Health Center)
• Carol Anne Zimmerman, DC LAC

• Nurse Practitioner in Ocean View, HI
• Providers in Ocean View, HI by specialty
• Nurse Practitioner in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.