Cawonda Ranee Wilson, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2023032312 Issued in IL

Practice address

2501 Chatham Rd
Springfield, IL 62704-4188

Phone

(253) 922-4027

Fax

(844) 222-0800

NPI assigned

May 15, 2023

Last updated

May 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Altea Medical Illinois PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Chicago Heights, IL
  • NPI 1447039227
  Medicare reassignment NPD
• CMC Healthcare LLC

  • Nurse Practitioner
  • Evanston, IL
  • NPI 1295432334
  Medicare reassignment NPD
• Curana Health of Illinois PC

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1891400156
  Medicare reassignment NPD
• Insight Physicians Care LLC

  • Adult Medicine Physician
  • Bloomingdale, IL
  • NPI 1154966018
  Medicare reassignment NPD
• Lutheran Social Services of Illinois

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1063637684

  Nurse Practitioner

  Medicare reassignment NPD
• Renew Wound Care of Illinois PLLC

  • Internal Medicine Physician
  • Naperville, IL
  • NPI 1578146882
  Medicare reassignment NPD
• Supportive Care of Illinois PC

  • Clinical Psychologist
  • Marshall, IL
  • NPI 1861199911

  Nurse Practitioner

  Medicare reassignment NPD
• Total Care Solutions, SC

  • Geriatric Psychiatry Physician
  • Westchester, IL
  • NPI 1447550603
  Medicare reassignment NPD
• Kane Wound Care LLC

  dba d/b/a Princeton Wound Care Center

  • Internal Medicine Physician
  • Princeton, NJ
  • NPI 1275869802

  IL

  Medicare reassignment NPD
• Post Acute Medical PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Lanham, MD
  • NPI 1730713025

  IL

  Medicare reassignment NPD
• CH Specialty Services Il PLLC

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1922707702
  Medicare reassignment
• Lutheran Social Services of Illinois

  dba Welcoming Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1144613746

  Nurse Practitioner

  NPD

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1417648148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6823 SUSSEX RD",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771745",
            "telephone_number": "708-682-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CHATHAM RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044188",
            "telephone_number": "253-922-4027",
            "fax_number": "844-222-0800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1203 W Augusta Blvd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606424327",
            "country_code": "US",
            "telephone_number": "773-248-2255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CAWONDA",
        "middle_name": "RANEE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209027707",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "2023032312",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "2023032312",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "IL",
            "license": "041469714",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED NURSE PRACTITIONER",
            "identifier": "209027707",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler Wilsman
• Amanda Wilson-Meyer
• Alyssa Wilson, PH.D., BCBA-D
• Amy Wilson
• Bradley A Wilson, MD
• Jennifer C Wilson, CRNA
• Laura Wilson, C-OTA
• Marla Kay Wilson, DPM
• Marty C Wilson, PA-C
• Michael J. Wilson, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Springfield, IL
• Providers in Springfield, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.