Individual provider Active NPI

Elicia D King-Wilson, PHARMD

  • Pharmacist
  • Winter Park, FL
National Provider Identifier
1407139520
Registry record updated Sep 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS 40267 Issued in FL
Practice address
1920 Aloma Ave
Winter Park, FL 32792-3207
Phone
(407) 628-1899
Fax
(407) 628-8842
NPI assigned
Sep 25, 2011
Last updated
Sep 25, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS 40267 FL Primary

Addresses

Primary practice location

1920 Aloma Ave
Winter Park, FL 32792-3207

Mailing address

1920 Aloma Ave
Winter Park, FL 32792-3207
Phone (407) 628-1899

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS 40267FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1316908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316908800000",
    "number": "1407139520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 ALOMA AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923207",
            "telephone_number": "407-628-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 ALOMA AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923207",
            "telephone_number": "407-628-1899",
            "fax_number": "407-628-8842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING-WILSON",
        "first_name": "ELICIA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-25",
        "last_updated": "2011-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS 40267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2011; 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.