Kadine Tashika Wilson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9116408 Issued in FL

Practice address

11141 Tortuga BND Apt 106
Orlando, FL 32825-6184

Phone

(954) 770-3544

NPI assigned

Sep 5, 2022

Last updated

Dec 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1295456770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11141 TORTUGA BND APT 106",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328256184",
            "telephone_number": "195-477-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11141 TORTUGA BND APT 106",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328256184",
            "telephone_number": "954-770-3544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KADINE",
        "middle_name": "TASHIKA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-05",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9116408",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James R Wilson, M.D.
• Janet Wilson
• Jekera Yashonda Y'Satis Wilson, DOULA
• Jennifer Cristina Wilson
• Jerrod Prescot Wilson, D.C.
• Kalay Wilson, PMHNP-BC, RN
• Katina L Wilson, ARNP
• Khalil Wilson
• Kimberly S Wilson, PHARMD
• Kimesha Wilson

• Physician Assistant in Orlando, FL
• Providers in Orlando, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; 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.