Charlene A Wilson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9111001 Issued in FL

Practice address

5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423

Phone

(305) 661-1515

NPI assigned

Jan 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holy Cross Hospital IncGroup PAC ID 1850298365, 299 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Cross Hospital Hospital, Ft Lauderdale, FL, CCN 100073

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cwilson2020100@direct.trinity-health.org

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

• Holy Cross Hospital Inc

  • Internal Medicine Physician
  • Ft. Lauderdale, FL
  • NPI 1467401877
  Medicare reassignment Care Compare group NPD
• Holy Cross Primary Care, Inc

  • Family Medicine Physician
  • Coral Springs, FL
  • NPI 1740637735
  Medicare reassignment
• Holy Cross Hospital, Inc

  • Health & Wellness Coach
  • Oakland Park, FL
  • NPI 1063207595
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Holy Cross Hospital Inc

  • Internal Medicine Physician
  • Ft. Lauderdale, FL
  • NPI 1467401877

  Hospital

  Care Compare affiliation
• Holy Cross Hospital Inc

  • General Acute Care Hospital
  • Ft Lauderdale, FL
  • NPI 1639197395
  Care Compare affiliation
• Holy Cross Hospital, Inc.

  • Urgent Care Clinic/Center
  • Boca Raton, FL
  • NPI 1376953125

  Hospital

  Care Compare affiliation
• Holy Cross Hospital, Inc.

  • Urgent Care Clinic/Center
  • Fort Lauderdale, FL
  • NPI 1386985190

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1518465772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462423",
            "telephone_number": "305-661-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462423",
            "telephone_number": "305-661-1515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 45th St",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334072413",
            "country_code": "US",
            "telephone_number": "754-210-4016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHARLENE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-23",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA DEPARTMENT OF HEALTH",
            "identifier": "PA9111001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen G. Williams, PA
• Lonneke Catalina Williams
• Sharae Micole Williams
• Tiffani Lynne Williams
• Taylor Wilmoth, DAT, LAT, ATC
• Claire Love Wilson, DPT
• Janet Go Wingkun, M.D.
• Wingless Angels Behavioral Services, LLC.
• Taylor Nicole Wingo
• Jennifer Lauren Wisniewski

• Physician Assistant in Coral Gables, FL
• Providers in Coral Gables, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.