Individual provider Active NPI

Alexandra Wilson, CPNP

  • Family Nurse Practitioner
  • Wauwatosa, WI
National Provider Identifier
1306356589
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8047-33 Issued in WI
Practice address
2500 N Mayfair Rd Ste 500
Wauwatosa, WI 53226-1415
Phone
(414) 249-2422
Fax
(414) 961-0298
NPI assigned
Oct 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 8047-33 WI
Family Nurse Practitioner 363LF0000X 8047-33 WI Primary

Addresses

Primary practice location

2500 N Mayfair Rd Ste 500
Wauwatosa, WI 53226-1415

Mailing address

2500 N Mayfair Rd Ste 500
Wauwatosa, WI 53226-1415
Phone (414) 249-2422

Other practice location 1

525 W River Woods Pkwy Ste 130
Glendale, WI 53212-1010
Phone (414) 249-2422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 19, 2025 through Dec 19, 2027

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2500 N Mayfair Rd
Suite 500
Wauwatosa, WI 53226-1415

Hospital & facility affiliations

  • Orthopaedic Hospital of Wisconsin Hospital, Glendale, WI, CCN 520194

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8047-33WIMDPediatric Nurse Practitioner

Hospital & facility affiliations 1

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": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1306356589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N MAYFAIR RD STE 500",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261415",
            "telephone_number": "414-249-2422",
            "fax_number": "414-961-0298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N MAYFAIR RD STE 500",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261415",
            "telephone_number": "414-249-2422",
            "fax_number": "414-961-0298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 W River Woods Pkwy Ste 130",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "WI",
            "postal_code": "532121010",
            "country_code": "US",
            "telephone_number": "414-249-2422",
            "fax_number": "414-961-0298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ALEXANDRA",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "8047-33",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "8047-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.