Active NPI
Nancy Joann Wilson, P.A. PHYSICIAN ASSIS
- Physician Assistant
- Tampa, FL
National Provider Identifier
1194016857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9105925
- Practice address
- 3838 W. Neptune St
Tampa, FL 33629 - Phone
- (800) 893-9698
- NPI assigned
- Apr 28, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9105925 | FL | Primary |
Addresses
Primary practice location
3838 W. Neptune St
Tampa, FL 33629
Mailing address
2311 W. Morrison Ave #27
Tampa, FL 33629
Phone (800) 893-9698
Other names 1
- Ms. Nancy Wilson Prindle
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9105925 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Observation Medical Group LLC | Current | Accepting new patients |
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 and National Provider Directory roles.
-
- Emergency Medicine Physician
- Tampa, FL
- NPI 1952763682
-
- Emergency Medicine Physician
- Tampa, FL
- NPI 1023397817
-
- Emergency Medicine Physician
- Tampa, FL
- NPI 1114977428
-
- Emergency Medicine Physician
- Sebring, FL
- NPI 1043661408
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631232000000",
"number": "1194016857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2311 W. MORRISON AVE #27",
"city": "TAMPA",
"state": "FL",
"postal_code": "33629",
"telephone_number": "800-893-9698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3838 W. NEPTUNE ST",
"city": "TAMPA",
"state": "FL",
"postal_code": "33629",
"telephone_number": "800-893-9698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "NANCY",
"middle_name": "JOANN",
"name_prefix": "Ms.",
"credential": "P.A. PHYSICIAN ASSIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-28",
"last_updated": "2021-09-10",
"certification_date": "2021-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9105925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NANCY",
"last_name": "PRINDLE",
"middle_name": "WILSON",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.