Individual provider Active NPI

Christina L Wilkerson, ARNP

  • Nurse Practitioner
  • Owensboro, KY
National Provider Identifier
1689948291
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3007369 Issued in KY
Practice address
2851 New Hartford Rd
Suite a
Owensboro, KY 42303-1320
Phone
(270) 240-2305
Fax
(270) 240-2252
NPI assigned
Feb 29, 2012
Last updated
Sep 13, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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 3007369 KY Primary

Addresses

Primary practice location

2851 New Hartford Rd
Suite a
Owensboro, KY 42303-1320

Mailing address

2851 New Hartford Rd a
Owensboro, KY 42303-1320
Phone (270) 240-2305

Other identifiers 1

IdentifierTypeStateIssuer
363L00000XOtherKYTAXONOMY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20120410000197 KY Practitioner - Nurse Practitioner 6305007881 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Ak Healthcare Management Inc Nurse Practitioner CurrentSince Jun 1, 2013 Accepting new patients
Brian M Payne Aprn PSC CurrentSince Jun 1, 2012 Accepting new patients
E.D. Mills, PLLC CurrentSince Dec 15, 2019 Accepting new patients

Locations

3600 Frederica St
Ste Ab
Owensboro, KY 42301
Phone (270) 684-0023

3600 Frederica St
Ste B
Owensboro, KY 42301
Phone (270) 684-0023

722 W Byers Ave
Owensboro, KY 42303
Phone (270) 478-5040

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20445/brand/1/csg/1/fhir/r4

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": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1689948291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 NEW HARTFORD RD A",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031320",
            "telephone_number": "270-240-2305",
            "fax_number": "270-240-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2851 NEW HARTFORD RD",
            "address_2": "SUITE A",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031320",
            "telephone_number": "270-240-2305",
            "fax_number": "270-240-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "CHRISTINA",
        "middle_name": "L",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-29",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3007369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "363L00000X",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.