Individual provider Active NPI

Mary Christine Wilkinson, NP

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1225124126
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
MW4878229 Issued in TX
Practice address
5521 Bellaire Dr S Ste 110
Fort Worth, TX 76109-5855
Phone
(817) 926-9642
Fax
(817) 926-1865
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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 MW4878229 TX Primary

Addresses

Primary practice location

5521 Bellaire Dr S Ste 110
Fort Worth, TX 76109-5855

Mailing address

5521 Bellaire Dr S Ste 110
Fort Worth, TX 76109-5855
Phone (817) 926-9642

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
I20241209001165 TX Practitioner - Nurse Practitioner 2264463470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health and Therapy CentersGroup PAC ID 7517338221, 12 clinicians

Practice addresses (Care Compare)

5521 Bellaire Dr S
Suite 110
Fort Worth, TX 76109-5855
Phone (817) 926-9642

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health and Therapy Centers Chiropractor CurrentSince Oct 15, 2024 Accepting new patients

Locations

5521 Bellaire Dr S
Ste 114
Ft Worth, TX 76109
Phone (817) 451-7979

5521 Bellaire Dr S
Ste 110
Ft Worth, TX 76109
Phone (817) 926-9642

Organizations & group practices 1

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1225124126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5521 BELLAIRE DR S STE 110",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761095855",
            "telephone_number": "817-926-9642",
            "fax_number": "817-926-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5521 BELLAIRE DR S STE 110",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761095855",
            "telephone_number": "817-926-9642",
            "fax_number": "817-926-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "MARY",
        "middle_name": "CHRISTINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "MW4878229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.