Amber Lee Wilson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

AMD 652 Issued in HI

Practice address

5407 Encino Oak Way
Killeen, TX 76542-5952

Phone

(218) 791-7011

NPI assigned

Sep 27, 2014

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

Other names 1

• Amber Lee Kuklinski Former name

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arcis Healthcare LLCGroup PAC ID 0042448748, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trident Medical Center Hospital, Charleston, SC, CCN 420079

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Arcis Healthcare, LLC

  • Orthopaedic Surgery Physician
  • North Charleston, SC
  • NPI 1902246077

  Medical

  Medicare reassignment Care Compare group NPD
• Arcis Healthcare, LLC

  • Durable Medical Equipment & Medical Supplies
  • Ladson, SC
  • NPI 1881406767
  NPD

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

• Trident Medical Center, LLC

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1366496937
  Care Compare affiliation

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

{
    "created_epoch": "1411776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1205239803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5407 ENCINO OAK WAY",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765425952",
            "telephone_number": "218-791-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5407 ENCINO OAK WAY",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765425952",
            "telephone_number": "218-791-7011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2880 Tricom St",
            "address_purpose": "LOCATION",
            "city": "N Charleston",
            "state": "SC",
            "postal_code": "294069171",
            "country_code": "US",
            "telephone_number": "843-797-5050",
            "fax_number": "843-797-3633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "AMBER",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-27",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "4479",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD 652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "KUKLINSKI",
            "middle_name": "LEE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brittney Marie Williamson, LCSW, M.S., CHES
• Patrella Williamson
• Yael Kreitman Willingham, M.D.
• Yaneka Willis, LPC
• Teyana Willridge
• Carol Lynn Wilson
• Contessa Lauren Wilson, LVN
• Elena Wilson, MD
• Geri Lynne Wilson
• Jason Paul Wilson, LMFT

• Physician Assistant in Killeen, TX
• Providers in Killeen, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.