Individual provider Active NPI

Kristina Anne Wilson

  • School Registered Nurse
  • Sebring, FL
National Provider Identifier
1578104295
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
RN9484761 Issued in FL
Practice address
7205 S George Blvd
Sebring, FL 33875-5847
Phone
(863) 381-6399
NPI assigned
Oct 3, 2019
Last updated
Oct 3, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 28115312A IN
School Registered Nurse 163WS0200X RN9484761 FL Primary

Addresses

Primary practice location

7205 S George Blvd
Sebring, FL 33875-5847

Mailing address

207 St Agnes St
Sebring, FL 33870-1829

Other practice location 1

207 St Agnes St
Sebring, FL 33870-1829
Phone (574) 354-1925

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL fl.gov

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

LicenseStateTypeSpecialty
28115312AINMDHome Health Registered Nurse
RN9484761FLMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1578104295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 ST AGNES ST",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338701829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7205 S GEORGE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338755847",
            "telephone_number": "863-381-6399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 St Agnes St",
            "address_purpose": "LOCATION",
            "city": "Sebring",
            "state": "FL",
            "postal_code": "338701829",
            "country_code": "US",
            "telephone_number": "574-354-1925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KRISTINA",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "IN",
            "license": "28115312A",
            "primary": false
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "FL",
            "license": "RN9484761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "fl.gov",
            "affiliation": "N",
            "address_1": "207 St Agnes St",
            "city": "Sebring",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338701829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.