Individual provider Active NPI

Kayee Veronica Wilson, FNP

  • Primary Care Nurse Practitioner
  • New Carrollton, MD
National Provider Identifier
1679879688
Registry record updated May 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
R189585 Issued in MD
Practice address
8201 Annapolis Rd
New Carrollton, MD 20784-3016
Phone
(301) 577-6222
NPI assigned
Feb 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X R189585 MD
Family Nurse Practitioner 363LF0000X R189585 MD
Primary Care Nurse Practitioner 363LP2300X R189585 MD Primary

Addresses

Primary practice location

8201 Annapolis Rd
New Carrollton, MD 20784-3016

Mailing address

8201 Annapolis Rd
New Carrollton, MD 20784-3016
Phone (301) 577-6222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111214000190 MD Practitioner - Nurse Practitioner 1759556152 Reassigns benefits to 1 organization
I20111229000488 DC Practitioner - Nurse Practitioner 1759556152 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1116 Mandarin Dr
Upper Marlboro, MD 20774-7024
Phone (202) 578-9001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R189585MDMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC CurrentSince Mar 1, 2020 Accepting new patients
Completely Centered Health LLC Family CurrentSince Aug 19, 2025 Accepting new patients
Marcellus R Cephas MD LLC CurrentSince Aug 16, 2020 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

175 Harry S Truman Pkwy
#J
Annapolis, MD 21401
Phone (443) 481-5400

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

7610 Carroll Ave
Ste 470
Takoma Park, MD 20912
Phone (301) 891-2077

7610 Carroll Ave
Ste 200
Takoma Park, MD 20912
Phone (301) 891-2077

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1679879688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 ANNAPOLIS RD",
            "city": "NEW CARROLLTON",
            "state": "MD",
            "postal_code": "207843016",
            "telephone_number": "301-577-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 ANNAPOLIS RD",
            "city": "NEW CARROLLTON",
            "state": "MD",
            "postal_code": "207843016",
            "telephone_number": "301-577-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KAYEE",
        "middle_name": "VERONICA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-09",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "R189585",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R189585",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R189585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Carrollton, MD

Sources for this page

Verify at the official NPI Registry.