Individual provider Active NPI

Pearlie Wilson-Natal, FNP

  • Family Nurse Practitioner
  • Douglas, AZ
National Provider Identifier
1194169102
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP4841 Issued in AZ
Practice address
100 E 5TH St
Douglas, AZ 85607-2859
Phone
(520) 364-7659
Fax
(520) 364-8541
NPI assigned
Apr 20, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP4841 AZ Primary

Addresses

Primary practice location

100 E 5TH St
Douglas, AZ 85607-2859

Mailing address

198 S Coronado Dr
Suite B
Sierra Vista, AZ 85635-6354
Phone (520) 439-0115

Other practice location 1

198 S Coronado Dr
Suite B
Sierra Vista, AZ 85635-6354
Phone (520) 439-0115

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address PEARLIEWILSONNATAL@cqch.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20130709000135 AZ Practitioner - Nurse Practitioner 8123268547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bisbee Hospital AssociationGroup PAC ID 5092626168, 69 clinicians

Practice addresses (Care Compare)

101 Cole Ave
Bisbee, AZ 85603-1327
Phone (520) 432-5383

Hospital & facility affiliations

  • Copper Queen Community Hospital Hospital, Bisbee, AZ, CCN 031312
  • Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeuo Health Family Current Accepting new patients
Bisbee Hospital Association CurrentSince Feb 3, 2014 Accepting new patients
Bisbee Hospital Association Current Accepting new patients
Bisbee Hospital Association CurrentSince Feb 3, 2014 Accepting new patients
Bisbee Hospital Association Past Accepting new patients

Locations

101 Cole Ave
Bisbee, AZ 85603
Phone (520) 432-5383

100 E 5th St
Douglas, AZ 85607
Phone (520) 364-7659

10524 E Highway 92
Hereford, AZ 85615
Phone (520) 366-0300

Interoperability endpoints

  • Direct secure messaging: pearliewilsonnatal@cqch.cernerdirect.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1366416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1194169102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 S CORONADO DR",
            "address_2": "SUITE B",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856356354",
            "telephone_number": "520-439-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 5TH ST",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856072859",
            "telephone_number": "520-364-7659",
            "fax_number": "520-364-8541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "198 S Coronado Dr",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Sierra Vista",
            "state": "AZ",
            "postal_code": "856356354",
            "country_code": "US",
            "telephone_number": "520-439-0115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON-NATAL",
        "first_name": "PEARLIE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-20",
        "last_updated": "2022-08-12",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP4841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PEARLIEWILSONNATAL@cqch.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Copper Queen Hospital  Douglas RHC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "100 E 5th St",
            "city": "Douglas",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "856072859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Douglas, AZ

Sources for this page

Verify at the official NPI Registry.