Active NPI
Daniel Wilburn
- Family Nurse Practitioner
- Washington, DC
National Provider Identifier
1083457402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 0102482-C-NP
- Practice address
- 2121 I St NW # 405
Washington, DC 20052-0086 - Phone
- (202) 908-8594
- NPI assigned
- Jun 13, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0102482-C-NP | CO | Primary |
Addresses
Primary practice location
2121 I St NW # 405
Washington, DC 20052-0086
Mailing address
1040 Newton St NE Apt 1
Washington, DC 20017-1713
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 |
|---|---|---|---|
| 0102482-C-NP | CO | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718236800000",
"number": "1083457402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1040 NEWTON ST NE APT 1",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200171713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 I ST NW # 405",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200520086",
"telephone_number": "202-908-8594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILBURN",
"first_name": "DANIEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-06-13",
"last_updated": "2024-06-13",
"certification_date": "2024-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "CO",
"license": "0102482-C-NP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.