Active NPI
Beverley Maria Wilson
- Licensed Practical Nurse
- Orange, NJ
National Provider Identifier
1457673386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 280338-1
- Practice address
- 765 Vose Ave
Unit B10
Orange, NJ 07050-1060 - Phone
- (973) 677-9711
- NPI assigned
- Feb 19, 2010
- Last updated
- Nov 1, 2010
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 280338-1 | NY | Primary |
Addresses
Primary practice location
765 Vose Ave
Unit B10
Orange, NJ 07050-1060
Mailing address
765 Vose Ave
Unit B10
Orange, NJ 07050-1060
Phone (973) 677-9711
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 |
|---|---|---|---|
| 280338-1 | NY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288569600000",
"number": "1457673386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "765 VOSE AVE",
"address_2": "UNIT B10",
"city": "ORANGE",
"state": "NJ",
"postal_code": "070501060",
"telephone_number": "973-677-9711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "765 VOSE AVE",
"address_2": "UNIT B10",
"city": "ORANGE",
"state": "NJ",
"postal_code": "070501060",
"telephone_number": "973-677-9711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "BEVERLEY",
"middle_name": "MARIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-19",
"last_updated": "2010-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "280338-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.