Individual provider Active NPI

Caroline Wilkinson, NURSE PRACTITIONER

  • Primary Care Nurse Practitioner
  • Broomall, PA
National Provider Identifier
1104474394
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
SP019931 Issued in PA
Practice address
725 Winchester Rd
Broomall, PA 19008-3432
Phone
(610) 731-7636
NPI assigned
Aug 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X LP-0010644 DE
Primary Care Nurse Practitioner 363LP2300X SP019931 PA Primary

Addresses

Primary practice location

725 Winchester Rd
Broomall, PA 19008-3432

Mailing address

725 Winchester Rd
Broomall, PA 19008-3432
Phone (610) 731-7636

Other practice location 1

236 W Allegheny Ave Ste 115A
Philadelphia, PA 19133-3629
Phone (215) 970-5629

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220816003924 PA Practitioner - Nurse Practitioner 0648653162 Reassigns benefits to 6 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP-0010644DEMDAdult Health Nurse Practitioner
SP019931PAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Guffanti Wound Associates PLLC CurrentSince Jan 6, 2023 Accepting new patients
Ennoble HC NJ PC CurrentSince May 13, 2024 Accepting new patients
Ocean Wounds PA PLLC CurrentSince Jun 20, 2025 Accepting new patients
HC Pennsylvania P.C. CurrentSince Aug 14, 2025 Accepting new patients
Encore Clinical Services - PA LLC CurrentSince Aug 1, 2023 Accepting new patients
Tri-County Hospitalists, LLC CurrentSince Jul 1, 2022 Accepting new patients
Riverside Physician Services Inc Past Accepting new patients

Locations

2 University Plz
Ste 204
Hackensack, NJ 07601
Phone (201) 564-0142

15 America Ave
Unit 103
Lakewood, NJ 08701
Phone (732) 631-4358

200 Rittenhouse Cir
Ste 4
Bristol, PA 19007
Phone (267) 225-1295

325 Chestnut St
Ste 800
Philadelphia, PA 19106
Phone 9732411356 ext. 11356

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

507 Kimberton Rd
Phoenixville, PA 19460
Phone (610) 243-9117

1243 Skytop Mountain Rd
Port Matilda, PA 16870
Phone (814) 499-3009

1130 W Chester Pike
West Chester, PA 19382
Phone (215) 815-7500

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 7

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": "1567123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1104474394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 WINCHESTER RD",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083432",
            "telephone_number": "610-731-7636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WINCHESTER RD",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083432",
            "telephone_number": "610-731-7636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "236 W Allegheny Ave Ste 115A",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191333629",
            "country_code": "US",
            "telephone_number": "215-970-5629",
            "fax_number": "267-686-6071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "CAROLINE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-30",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "DE",
            "license": "LP-0010644",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP019931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomall, PA

Sources for this page

Verify at the official NPI Registry.