Individual provider Active NPI

Christine Wilson, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Oakland, FL
National Provider Identifier
1124402888
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
ARNP9256129 Issued in FL
Practice address
710 Regina Cir
Oakland, FL 34787-8961
Phone
(407) 654-8588
NPI assigned
Jul 13, 2015
Last updated
Jun 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN9256129 FL
Adult Health Nurse Practitioner 363LA2200X ARNP9256129 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP9256129 FL Primary

Addresses

Primary practice location

710 Regina Cir
Oakland, FL 34787-8961

Mailing address

710 Regina Cir
Oakland, FL 34787-8961
Phone (407) 654-8588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190402000122 FL Practitioner - Nurse Practitioner 4688915655 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9256129FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MCR Health, Inc. CurrentSince Sep 1, 2020 Accepting new patients
Balanced Wellbeing LLC CurrentSince May 16, 2020 Accepting new patients
MCR Health, Inc. CurrentSince Sep 1, 2020 Accepting new patients

Locations

725 N 12th Ave
#B
Arcadia, FL 34266
Phone (863) 494-1242

3200 SW 34th Ave
Ste 701
Ocala, FL 34474
Phone (354) 445-1200

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1124402888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 REGINA CIR",
            "city": "OAKLAND",
            "state": "FL",
            "postal_code": "347878961",
            "telephone_number": "407-654-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 REGINA CIR",
            "city": "OAKLAND",
            "state": "FL",
            "postal_code": "347878961",
            "telephone_number": "407-654-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-13",
        "last_updated": "2023-06-07",
        "certification_date": "2023-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9256129",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9256129",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP9256129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, FL

Sources for this page

Verify at the official NPI Registry.