Kathryn Rose Wilson, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN2310642 Issued in MA

Practice address

19 Pierce Ave
Fitchburg, MA 01420-7160

Phone

(978) 577-0437

Fax

(978) 345-4730

NPI assigned

Dec 8, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Pediatrics West, PC

  • Pediatrics Physician
  • Westford, MA
  • NPI 1598850281
  Medicare reassignment NPD
• Child and Family Psychological Services, PLLC

  dba LifeStance Health

  • Psychologist
  • Norwood, MA
  • NPI 1912987181
  NPD
• Specialty West PLLC

  • Allergy & Immunology Physician
  • Westford, MA
  • NPI 1518383538
  NPD (past)

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1184491201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 PIERCE AVE",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014207160",
            "telephone_number": "785-770-4379",
            "fax_number": "978-345-4730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 PIERCE AVE",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014207160",
            "telephone_number": "978-577-0437",
            "fax_number": "978-345-4730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KATHRYN",
        "middle_name": "ROSE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-08",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MA",
            "license": "RN2310642",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2310642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Shirk Williams, LMHC
• Alyssa Williamson, M.S., B.A.
• Amanda Wilson
• Anthony Lee Wilson
• Carolen Nasser Wilson
• Nancy S Wilson, BA
• Ryan Wilson, B.A.
• Melissa Wish, RE, REGISTERED ELECT
• Raymond Edward Wolejko
• Aaron Alistair-Andre Wolfe

• Pediatric Nurse Practitioner in Fitchburg, MA
• Providers in Fitchburg, MA by specialty
• Pediatric Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.