Kristina Lee Wilson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11025855 Issued in FL

Practice address

542435 US Highway 1
Callahan, FL 32011-3497

Phone

(904) 507-4623

NPI assigned

Apr 14, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Rural Urgent Care LLC

  • Urgent Care Clinic/Center
  • Quincy, FL
  • NPI 1881353670
  Medicare reassignment NPD
• Rural Urgent Care LLC

  • Rural Health Clinic/Center
  • Eufaula, AL
  • NPI 1588450316
  NPD
• Rural Urgent Care LLC

  • Urgent Care Clinic/Center
  • Centre, AL
  • NPI 1932586476
  NPD

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

{
    "created_epoch": "1681430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1700572443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 1ST AVE N UNIT 3",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352031866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542435 US HIGHWAY 1",
            "city": "CALLAHAN",
            "state": "FL",
            "postal_code": "320113497",
            "telephone_number": "904-507-4623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KRISTINA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-14",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "RN9486864",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11025855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margo Walton
• Waters Homecare
• Daniel Robert Weaver, D.C. P.A.
• Tyler X Wester, DO
• Tyshell N/a Wilkinson, APRN, FNP-C
• Kimberly Martin Wood

• Family Nurse Practitioner in Callahan, FL
• Providers in Callahan, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.