Sean M Wilder, APRN-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

APRN11001912 Issued in FL

Practice address

1919 W Swann Ave FL 2
Tampa, FL 33606-2417

Phone

(813) 254-7079

Fax

(813) 443-8164

NPI assigned

Jul 9, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sean.wilder@direct.mybaycare.org

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.

• Sweetwater Hospital Association

  • Obstetrics & Gynecology Physician
  • Sweetwater, TN
  • NPI 1558995399
  NPD (past)

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

{
    "created_epoch": "1436400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1275916165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST FL 2",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-532-1355",
            "fax_number": "813-635-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 W SWANN AVE FL 2",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062417",
            "telephone_number": "813-254-7079",
            "fax_number": "813-443-8164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "SEAN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "APRN-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-09",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "28224842A",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11001912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102642600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Wilde
• Courtney Wilder-Whiting, FNP-C, PMHNP-C
• Casandra Wilder
• Rebecca E Wilder, DPT
• Richard Barry Wilder, M.D.
• Linda Mae Wildfong, BS
• Lesline Wallace Wildman, C.R.N.A.
• Jill Wileden, LCSW
• Mari Wilensky, MSW, LCSW
• David A Wiles, APRN-C

• Primary Care Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; 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.