Charla F Wilson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5158 Issued in TN

Practice address

9075 Sandidge Center Cove
Olive Branch, MS 38654

Phone

(662) 895-4949

Fax

(662) 895-6746

NPI assigned

Oct 17, 2005

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

Medicare fee-for-service enrollment

Enrolled in TN, MS2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Uhs of Parkwood IncGroup PAC ID 6002002276, 3 clinicians

Olive Branch Family Medical CenterGroup PAC ID 2567351984, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Healthcare - Olive Branch Hospital Hospital, Olive Branch, MS, CCN 250167

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charla.wilson.p1@direct.obfmc.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Olive Branch Family Medical Center

  • Family Medicine Physician
  • Olive Branch, MS
  • NPI 1629018478
  Medicare reassignment Care Compare group NPD
• Uhs of Parkwood Inc

  dba Parkwood Behavioral Health System

  • Psychiatric Hospital
  • Olive Branch, MS
  • NPI 1093785859
  Medicare reassignment Care Compare group NPD
• Uhs of Parkwood Inc

  dba Parkwood Behavioral Health System

  • Psychiatry Physician
  • Olive Branch, MS
  • NPI 1639345697
  NPD

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

• Methodist Healthcare - Olive Branch Hospital

  • General Acute Care Hospital
  • Olive Branch, MS
  • NPI 1912341439
  Care Compare affiliation

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526428800000",
    "number": "1225027832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6248 CAROLOT LN",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381351196",
            "telephone_number": "901-372-8486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9075 SANDIDGE CENTER COVE",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "38654",
            "telephone_number": "662-895-4949",
            "fax_number": "662-895-6746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHARLA",
        "middle_name": "F",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-17",
        "last_updated": "2018-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "5158",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "R844603",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danny Williams Jr.
• Gheri Williams, RN
• Latonia Williams, NURSE PRACTITIONER
• Mallory Williams, LMSW LSSW
• Serenity Williams, P-LPC
• Windstone Dental LLC
• Kevin Scott Winter, PHARMD
• Carolyn Wong
• Fred Gaddis Woods, D.C.
• Marshun Wright

• Family Nurse Practitioner in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; 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.