NPIMap

Individual provider Active NPI

Gina G Wilson, FNP

  • Family Nurse Practitioner
  • Manning, SC
National Provider Identifier
1073581047
Registry record updated Jan 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN562 Issued in SC
Practice address
1013 Professional CT
Manning, SC 29102-2827
Phone
(803) 433-7444
Fax
(803) 433-7448
NPI assigned
Mar 8, 2006
Last updated
Jan 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2014

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 APN562 SC Primary

Addresses

Primary practice location

1013 Professional CT
Manning, SC 29102-2827

Mailing address

1013 Professional CT
Manning, SC 29102-2827
Phone (803) 433-7444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070913000021 SC Practitioner - Nurse Practitioner 0345334934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Colonial Family Practice LLCGroup PAC ID 9931017118, 58 clinicians

Practice addresses (Care Compare)

1013 Professional CT
Suite C
Manning, SC 29102-2827
Phone (803) 433-7425

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN562SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Colonial Family Practice, LLC Family CurrentSince Jan 1, 2017 Accepting new patients
Colonial Family Practice, LLC CurrentSince Jan 1, 2017 Accepting new patients
Colonial Family Practice, LLC Family Current Accepting new patients
Colonial Family Practice, LLC Family Past Accepting new patients
Colonial Family Practice, LLC Past Accepting new patients
Colonial Family Practice, LLC Family Past Accepting new patients
Colonial Family Practice, LLC Family Past Accepting new patients
Colonial Family Practice, LLC Past Accepting new patients
Colonial Family Practice - Manning Family Past Accepting new patients
Colonial Family Practice, LLC Past Accepting new patients
Colonial Family Practice, LLC Family Past Accepting new patients
Colonial Family Practice, LLC Family Past Accepting new patients
Colonial Family Practice & Ambulatory Care Center Family Past Accepting new patients
Colonial Family Practice, LLC Family Past Accepting new patients

Locations

1124 Little St
Camden, SC 29020
Phone (803) 432-9899

4700 Forest Dr
Columbia, SC 29206
Phone (803) 256-1511

1013 Professional Ct
Ste A
Manning, SC 29102
Phone (803) 433-7425

1013 Professional Ct
Ste C
Manning, SC 29102
Phone (803) 433-7425

1036 Professional Ct
Manning, SC 29102
Phone (803) 433-5220

308 W Wesmark Blvd
Sumter, SC 29150
Phone (803) 905-1200

325 Broad St
Sumter, SC 29150

325 Broad St
Ste 100
Sumter, SC 29150

325 Broad St
Ste 200
Sumter, SC 29150
Phone (803) 775-4469

327 Broad St
Sumter, SC 29150
Phone (803) 774-2781

385 W Wesmark Blvd
Sumter, SC 29150
Phone 8037735227 ext. 1013

674 W Liberty St
Sumter, SC 29150
Phone 80377352276010

742 W Liberty St
Sumter, SC 29150
Phone (803) 773-3391

Interoperability endpoints

  • Direct secure messaging: gina.wilson@colonialhealthcare.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/CIHIBD

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1073581047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 PROFESSIONAL CT",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291022827",
            "telephone_number": "803-433-7444",
            "fax_number": "803-433-7448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 PROFESSIONAL CT",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291022827",
            "telephone_number": "803-433-7444",
            "fax_number": "803-433-7448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "GINA",
        "middle_name": "G",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "APN562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manning, SC

Sources for this page

Verify at the official NPI Registry.