Anita Jane Wilkerson, CRNP
Individual provider Active NPI Family Nurse Practitioner · Crownpoint, NM
NPI 1326286089 · NPPES record last updated Aug 24, 2018
Key facts
- NPI
- 1326286089
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R175091 (MD)
- Practice address
- Junction of Highway 371 & Route 9
Crownpoint, NM 97313 - Phone
- (505) 786-5291
- NPI assigned
- Feb 3, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- DHHS PHS Naihs Crownpoint Hospital
Practice addresses (Care Compare)
3 Navarre St
Thoreau Clinic
Thoreau, NM 87323-2147
Phone (505) 862-8250
Junction of Hwy 371 Navajo RT 9
Crownpoint, NM 87313-0358
Phone (505) 786-5291
PO Box
Suite 358
Crownpoint, NM 87313-0358
Hospital & facility affiliations
- Crownpoint Healthcare Facility
- Cibola General Hospital
- San Juan Regional Medical Center Inc
- Rehoboth McKinley Christian Health Care Services
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.65 of 100
- Quality
- 68.3
- Improvement activities
- 40
- Cost
- 86.97
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181022000481 | TX | Practitioner - Nurse Practitioner | 0648523654 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R175091 | MD | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thoreau Clinic | Current |
Accepting new patients | |
| Pueblo Pintado Clinic | Current | Accepting new patients | |
| DHHS PHS Naihs Crownpoint Hospital | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R175091 | MD | |
| Family Nurse Practitioner | 363LF0000X | R175091 | MD | Yes |
Addresses
Primary practice location
Junction of Highway 371 & Route 9
Crownpoint, NM 97313
Mailing address
P.O. Box 358
Junction of Highway 371 & Route 9
Crownpoint, NM 87313-0358
Phone (505) 786-5291
Other names
- Miss Anita J Kellogg
Other providers in Crownpoint, NM
- Tran Ngoc Tran
- US DHHS Crownpoint Healthcare Facility
- Bobilyn Jo Waite
- Keith Warshany
- Nazret Gaim Weldeghiorgis
- Carla Alene Williams
- Rebecca Wong
- Adena Suk Wai Yau
- Sunkoo Yoon
All providers in Crownpoint, NM · Family Nurse Practitioner in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.