Active NPI
Brea Wilson
- Adult Companion
- Jacksonville, FL
National Provider Identifier
1346153277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- License
- 240973
- Practice address
- 4758 Playpen Dr
Jacksonville, FL 32210-1421 - Phone
- (904) 352-9686
- NPI assigned
- Sep 23, 2026
- Last updated
- Sep 23, 2026
- 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 |
|---|---|---|---|---|
| Adult Companion | 372600000X | 240973 | FL | Primary |
Addresses
Primary practice location
4758 Playpen Dr
Jacksonville, FL 32210-1421
Mailing address
4758 Playpen Dr
Jacksonville, FL 32210-1421
Phone (904) 352-9686
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790121600000",
"number": "1346153277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4758 PLAYPEN DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322101421",
"telephone_number": "904-352-9686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4758 PLAYPEN DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322101421",
"telephone_number": "904-352-9686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "BREA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-09-23",
"last_updated": "2026-09-23",
"certification_date": "2026-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": "FL",
"license": "240973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.