Tynaka Kwans Wilson, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

22090 Issued in SC

Practice address

2724 W Palmetto St Ste 12
Florence, SC 29501-4909

Phone

(843) 687-9852

Fax

(937) 606-3077

NPI assigned

Sep 4, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Virtuous Primary CareGroup PAC ID 9638540180, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tynaka.wilson.1@7602.direct.athenahealth.com

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.

• Virtuous Primary Care

  • Family Nurse Practitioner
  • Florence, SC
  • NPI 1508515842
  Medicare reassignment Care Compare group NPD Authorized official
• SC House Calls Inc

  • Family Medicine Physician
  • Columbia, SC
  • NPI 1518048859
  Medicare reassignment NPD
• SC House Calls Inc

  • Oxygen Equipment & Supplies (DME)
  • Columbia, SC
  • NPI 1073201711
  NPD

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1295217545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2724 W PALMETTO ST STE 12",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014909",
            "telephone_number": "843-687-6952",
            "fax_number": "937-606-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 W PALMETTO ST STE 12",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014909",
            "telephone_number": "843-687-9852",
            "fax_number": "937-606-3077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 Dixie St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "SC",
            "postal_code": "295012321",
            "country_code": "US",
            "telephone_number": "843-206-5346",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Doctor Cir",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036502",
            "country_code": "US",
            "telephone_number": "800-491-0909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TYNAKA",
        "middle_name": "KWANS",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "22090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole S. Wilson
• Sharon Wilson
• Stormi Wilson
• Tanysha Gibbs Wilson, MA CCC-SLP L
• Toni Marie Wilson
• William Bailey Winburn II, PHARMACIST
• Windham Gynecology, LLC
• Jayme Windham
• Nancy Quintero Windham, M.D.
• Dora Windsorova, PH.D.

• Family Nurse Practitioner in Florence, SC
• Providers in Florence, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.