Individual provider Active NPI

Wiltse Crompton, CPNP

  • Pediatric Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1164623716
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
20000337 Issued in MN
Practice address
3433 Broadway St NE
Minneapolis, MN 55413-1740
Phone
(612) 617-4600
NPI assigned
May 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X R 143878-1 MN
Pediatric Nurse Practitioner 363LP0200X 20000337 MN Primary

Addresses

Primary practice location

3433 Broadway St NE
Minneapolis, MN 55413-1740

Mailing address

1504 Washburn Ave N
Minneapolis, MN 55411-2845
Phone (612) 998-5865

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
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R 143878-1MNMDPediatric Registered Nurse
20000337MNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatric Services of Minnesota, LLC Past Accepting new patients

Organizations & group practices 1

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1164623716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 WASHBURN AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554112845",
            "telephone_number": "612-998-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3433 BROADWAY ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131740",
            "telephone_number": "612-617-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROMPTON",
        "first_name": "WILTSE",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MN",
            "license": "R 143878-1",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "20000337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.