Individual provider Active NPI

Christina Gonzalez-Wilson, W.H.N.P, M.S.N.

  • Nurse Practitioner
  • Hampton, VA
National Provider Identifier
1689830986
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024166275 Issued in VA
Practice address
2240 Coliseum Dr Ste B
Hampton, VA 23666-5903
Phone
(757) 838-7277
NPI assigned
Aug 6, 2008
Last updated
Oct 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024166275 VA Primary

Addresses

Primary practice location

2240 Coliseum Dr Ste B
Hampton, VA 23666-5903

Mailing address

860 Omni Blvd Ste 101
Newport News, VA 23606-4430
Phone (757) 232-8769

Other identifiers 1

IdentifierTypeStateIssuer
0024166275OtherVALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20191210001996 VA Practitioner - Nurse Practitioner 9436582160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13195 Warwick Blvd
2C
Newport News, VA 23602-8313
Phone (804) 877-4221

2240 Coliseum Dr
Suite B
Hampton, VA 23666-5903
Phone (757) 223-9794

860 Omni Blvd
Newport News, VA 23606-4430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
0024166275VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Oct 1, 2019 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Oct 1, 2019 Accepting new patients
Mid-Atlantic Womens Care PLC Past Accepting new patients
Mid-Atlantic Womens Care PLC Past Accepting new patients

Locations

100 Volvo Pkwy
Ste 100
Chesapeake, VA 23320

13195 Warwick Blvd
Ste 2C
Newport News, VA 23602
Phone (804) 877-4221

827 Diligence Dr
Ste 100
Newport News, VA 23606

860 Omni Blvd
Newport News, VA 23606
Phone (757) 369-8138

860 Omni Blvd
Ste 101
Newport News, VA 23606
Phone (757) 223-9794

860 Omni Blvd
Ste 110
Newport News, VA 23606
Phone (757) 223-9794

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1689830986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD STE 101",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064430",
            "telephone_number": "757-232-8769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 COLISEUM DR STE B",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665903",
            "telephone_number": "757-838-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ-WILSON",
        "first_name": "CHRISTINA",
        "credential": "W.H.N.P, M.S.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-06",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024166275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0024166275",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.