Celina R Wilson

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

043.106349 Issued in IL

Practice address

106 S Country Fair Dr Ste C
Champaign, IL 61821-3064

Phone

(217) 373-8200

NPI assigned

Apr 22, 2024

Last updated

Apr 22, 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 1

Addresses

Other names 1

• Celina Vinson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Champaign Treatment Center, LLC

  dba MedMark Treatment Centers Champaign

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Champaign, IL
  • NPI 1033460498
  NPD

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1538914635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 S COUNTRY FAIR DR STE C",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618213064",
            "telephone_number": "217-373-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 S COUNTRY FAIR DR STE C",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618213064",
            "telephone_number": "217-373-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CELINA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043.106349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CELINA",
            "last_name": "VINSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Naomi Willis
• Willow Counseling LLC
• Wilma L. Bryant Psychotherapy LTD (Wilma L Bryant LCSW)
• Carol Wilson-Smith, L.C.S.W.
• Angela Renee Wilson, LPC, NCC
• Henry Eugene Wilson III, OTR/L
• Isaiah Wilson
• Jessica Wilson
• Kathryn A Wilson, MD
• Kristen J. Wilson, MSW

• Licensed Practical Nurse in Champaign, IL
• Providers in Champaign, IL by specialty
• Licensed Practical Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.