Individual provider Active NPI

Daniel Roy Wilcock

  • Registered Nurse
  • Richland, WA
National Provider Identifier
1609514371
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN61300153 Issued in WA
Practice address
1175 Carondelet Dr
Richland, WA 99354-3300
Phone
(509) 943-9104
NPI assigned
May 23, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN61300153 WA Primary

Addresses

Primary practice location

1175 Carondelet Dr
Richland, WA 99354-3300

Mailing address

1011 Comstock St
Richland, WA 99352-4523
Phone (541) 519-7820

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
RN61300153WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1609514371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 COMSTOCK ST",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524523",
            "telephone_number": "541-519-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 CARONDELET DR",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993543300",
            "telephone_number": "509-943-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOCK",
        "first_name": "DANIEL",
        "middle_name": "ROY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61300153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; 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.