NPIMap

Individual provider Active NPI

Peter G. Wilcox, ARNP

  • Gerontology Nurse Practitioner
  • Silverdale, WA
National Provider Identifier
1285049965
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP60470374 Issued in WA
Practice address
2011 NW Myhre PL
Silverdale, WA 98383-8561
Phone
(360) 830-1600
Fax
(253) 759-4699
NPI assigned
Jun 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60470374 WA
Gerontology Nurse Practitioner 363LG0600X AP60470374 WA Primary

Addresses

Primary practice location

2011 NW Myhre PL
Silverdale, WA 98383-8561

Mailing address

2011 NW Myhre PL
Silverdale, WA 98383-8561
Phone (360) 830-1600

Other practice location 1

1400 E. Kincaid Street
Skagit Regional Clinics
Mount Vernon, WA 98274-4127
Phone (360) 428-2592

Other identifiers 1

IdentifierTypeStateIssuer
2038792MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address peter.wilcox@tdc.directbygreenway.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141010000637 WA Practitioner - Nurse Practitioner 6305066572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

2011 NW Myhre PL
Silverdale, WA 98383-8561
Phone (360) 830-1600

Hospital & facility affiliations

  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039
  • Olympic Medical Center Hospital, Port Angeles, WA, CCN 500072
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • Jefferson Healthcare Hospital, Port Townsend, WA, CCN 501323
  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Nov 1, 2019 Accepting new patients
Franciscan Medical Group CurrentSince Nov 1, 2019 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

2011 NW Myhre Pl
Silverdale, WA 98383
Phone (360) 830-1600

9621 Ridgetop Blvd NW
Silverdale, WA 98383
Phone (360) 782-3300

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: peter.wilcox@tdc.directbygreenway.com

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1403308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1285049965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 NW MYHRE PL",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838561",
            "telephone_number": "360-830-1600",
            "fax_number": "253-759-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 NW MYHRE PL",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838561",
            "telephone_number": "360-830-1600",
            "fax_number": "253-759-4699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 E. Kincaid Street",
            "address_2": "Skagit Regional Clinics",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982744127",
            "country_code": "US",
            "telephone_number": "360-428-2592",
            "fax_number": "360-428-6470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "PETER",
        "middle_name": "G.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-21",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60470374",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP60470374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2038792",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "peter.wilcox@tdc.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2011 NW Myhre Pl",
            "city": "Silverdale",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983838561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

Verify at the official NPI Registry.