Individual provider Active NPI

Carol Wilson, LPN

  • Licensed Practical Nurse
  • Biloxi, MS
National Provider Identifier
1699862078
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
P165786 Issued in MS
Practice address
8796 N Paulettes PL
Biloxi, MS 39532-7410
Phone
(228) 392-3095
Fax
(228) 392-3095
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X P165786 MS Primary

Addresses

Primary practice location

8796 N Paulettes PL
Biloxi, MS 39532-7410

Mailing address

8796 N Paulettes PL
Biloxi, MS 39532-7410
Phone (228) 392-3095

Other identifiers 1

IdentifierTypeStateIssuer
00770265MedicaidMS

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
P165786MSMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1699862078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8796 N PAULETTES PL",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395327410",
            "telephone_number": "228-392-3095",
            "fax_number": "228-392-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8796 N PAULETTES PL",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395327410",
            "telephone_number": "228-392-3095",
            "fax_number": "228-392-3095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MS",
            "license": "P165786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00770265",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.