Individual provider Active NPI

Caprece Wilson, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Maricopa, AZ
National Provider Identifier
1255130779
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
252305 Issued in AZ
Practice address
41704 W Smith Enke Rd
Maricopa, AZ 85138-2709
Phone
(623) 300-3526
NPI assigned
Mar 8, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 252305 AZ Primary

Addresses

Primary practice location

41704 W Smith Enke Rd
Maricopa, AZ 85138-2709

Mailing address

14990 W Heritage Oak Way
Surprise, AZ 85374-3410
Phone (224) 469-0505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20250925001460 AZ Practitioner - Nurse Practitioner 8921516980 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Siren Medical PCGroup PAC ID 6608298419, 19 clinicians

Practice addresses (Care Compare)

14631 N Cave Creed Rd
Suite 104
Phoenix, AZ 85022-4100
Phone (602) 715-2568

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ganesha Institute of Neurology and Psychiatry SC Psychiatric/Mental Health CurrentSince Aug 17, 2025 Accepting new patients
Ganesha Institute of Neurology and Psychiatry SC CurrentSince Aug 17, 2025 Accepting new patients
Siren Medical PC CurrentSince Sep 12, 2025 Accepting new patients

Locations

14631 N Cave Creek Rd
Ste 104
Phoenix, AZ 85022
Phone (602) 715-2568

2999 N 44th St
Ste 220
Phoenix, AZ 85018
Phone (602) 288-4059

14631 N Cave Creek Rd
Phoenix, AZ 85022
Phone (623) 624-7425

9327 N 3rd St
Ste 200
Phoenix, AZ 85020
Phone (520) 595-5500

Organizations & group practices 3

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": "1741392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1255130779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14990 W HERITAGE OAK WAY",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853743410",
            "telephone_number": "224-469-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41704 W SMITH ENKE RD",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851382709",
            "telephone_number": "623-300-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CAPRECE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-08",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "252305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maricopa, AZ

Sources for this page

Verify at the official NPI Registry.