NPIMap

Organization Active NPI

C. H. Wilkinson Physician Network

Doing business as The Clinic at Walmart, Store #75

  • Nurse Practitioner
  • Pineville, LA
National Provider Identifier
1346567831
Registry record updated Apr 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
C. H. WILKINSON PHYSICIAN NETWORK
Doing business as
The Clinic at Walmart, Store #75
Practice address
3636 Monroe Hwy
Pineville, LA 71360-4127
Phone
(318) 641-3137
NPI assigned
Apr 23, 2010
Last updated
Apr 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

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

Authorized official

Name
Donna J Mikulecky
Title
Ceo President
Phone
(713) 277-2202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X Primary

Addresses

Primary practice location

3636 Monroe Hwy
Pineville, LA 71360-4127

Mailing address

1700 West Loop S
Suite 400B
Houston, TX 77027-3005
Phone (713) 227-2222

Other identifiers 1

IdentifierTypeStateIssuer
1445266MedicaidLA

Other names 1

  • The Clinic at Walmart, Store #75 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CH Wilkinson Physician32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271980800000",
    "number": "1346567831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 WEST LOOP S",
            "address_2": "SUITE 400B",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770273005",
            "telephone_number": "713-227-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 MONROE HWY",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604127",
            "telephone_number": "318-641-3137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C. H. WILKINSON PHYSICIAN NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A",
        "authorized_official_last_name": "MIKULECKY",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "713-277-2202"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1445266",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Clinic at Walmart, Store #75",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pineville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.