Individual provider Active NPI

Chriscellis P Wilson, BSN

  • Registered Nurse
  • Bronx, NY
National Provider Identifier
1205705464
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
878852 Issued in NY
Practice address
906 Eagle Ave Apt 3a
Bronx, NY 10456-7310
Phone
(917) 530-6690
NPI assigned
Nov 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 878852 NY Primary

Addresses

Primary practice location

906 Eagle Ave Apt 3a
Bronx, NY 10456-7310

Mailing address

906 Eagle Ave Apt 3a
Bronx, NY 10456-7310
Phone (917) 530-6690

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
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
878852NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1762214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1205705464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 EAGLE AVE APT 3A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104567310",
            "telephone_number": "917-530-6690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 EAGLE AVE APT 3A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104567310",
            "telephone_number": "917-530-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHRISCELLIS",
        "middle_name": "P",
        "credential": "BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-04",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "878852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.