Individual provider Active NPI

Nina Marie Wilson

  • Family Nurse Practitioner
  • Fort Cavazos, TX
National Provider Identifier
1215491717
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP140354 Issued in TX
Practice address
Carl R Darnall Army Medical Center
590 Medical Center Road
Fort Cavazos, TX 76544
Phone
(254) 288-8280
NPI assigned
Jan 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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 AP140354 TX Primary

Addresses

Primary practice location

Carl R Darnall Army Medical Center
590 Medical Center Road
Fort Cavazos, TX 76544

Mailing address

Carl R Darnall Army Medical Center
590 Medical Center Road
Fort Cavazos, TX 76544
Phone (254) 288-8280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190529002612 TX Practitioner - Nurse Practitioner 9335482652 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP140354TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Associates of Central Texas PA CurrentSince May 1, 2019 Accepting new patients
Premier Physicians-II, P.a. CurrentSince May 13, 2019 Accepting new patients

Locations

2201 Clear Creek Rd
Killeen, TX 76549
Phone (254) 519-8185

900 Austin Ave
Ste 1001
Waco, TX 76701
Phone (254) 224-8808

9110 Jordan Ln
Ste 200
Woodway, TX 76712
Phone (254) 399-0740

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1215491717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CARL R DARNALL ARMY MEDICAL CENTER",
            "address_2": "590 MEDICAL CENTER ROAD",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "254-288-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARL R DARNALL ARMY MEDICAL CENTER",
            "address_2": "590 MEDICAL CENTER ROAD",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "254-288-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "NINA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-29",
        "last_updated": "2025-06-18",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP140354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Cavazos, TX

Sources for this page

Verify at the official NPI Registry.