Active NPI
Kristin Mannina Wilson, OTRL
- Occupational Therapist
- Raleigh, NC
National Provider Identifier
1346742343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 11976
- Practice address
- 5301 Creedmoor Rd
Raleigh, NC 27612-3822 - Phone
- (919) 651-3803
- NPI assigned
- Mar 6, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 11976 | NC | Primary |
Addresses
Primary practice location
5301 Creedmoor Rd
Raleigh, NC 27612-3822
Mailing address
2029 Longwood Dr
Raleigh, NC 27612-2814
Phone (919) 280-1436
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11976 | NC | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539302400000",
"number": "1346742343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2029 LONGWOOD DR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276122814",
"telephone_number": "919-280-1436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5301 CREEDMOOR RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276123822",
"telephone_number": "919-651-3803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "KRISTIN",
"middle_name": "MANNINA",
"name_prefix": "Mrs.",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-06",
"last_updated": "2018-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "11976",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.