Active NPI
Theresa Russ Wilson, RN
- Public Health or Welfare Agency
- Greenville, NC
National Provider Identifier
1326104506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health or Welfare Agency
- License
- 098763
- Practice address
- 201 Government Cir
Greenville, NC 27834-8198 - Phone
- (252) 902-2349
- NPI assigned
- Dec 29, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | 098763 | NC | Primary |
Addresses
Primary practice location
201 Government Cir
Greenville, NC 27834-8198
Mailing address
3105 Tucker Dr
Greenville, NC 27858-6017
Phone (252) 353-2427
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 098763 | NC | MD | Public Health or Welfare Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326104506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3105 TUCKER DR",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278586017",
"telephone_number": "252-353-2427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 GOVERNMENT CIR",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278348198",
"telephone_number": "252-902-2349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "THERESA",
"middle_name": "RUSS",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": "NC",
"license": "098763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.