Michelle Wilson, APN-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP027848 Issued in PA

Practice address

107 Town Center Rd
King of Prussia, PA 19406-2330

Phone

(484) 750-5212

Fax

(484) 750-5212

NPI assigned

Aug 21, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

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.

• Live Family Care PLLC

  • Family Medicine Physician
  • King of Prussia, PA
  • NPI 1114631769
  Medicare reassignment NPD
• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment NPD
• Main Line Healthcare

  • Urgent Care Clinic/Center
  • Wynnewood, PA
  • NPI 1295214492
  NPD (past)

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1740064823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 W CHESTER PIKE STE 160",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732336",
            "telephone_number": "484-337-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 TOWN CENTER RD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062330",
            "telephone_number": "484-750-5212",
            "fax_number": "484-750-5212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 E Lancaster Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Wynnewood",
            "state": "PA",
            "postal_code": "190962100",
            "country_code": "US",
            "telephone_number": "484-565-1293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHELLE",
        "credential": "APN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP027848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Janine Williams, M.D.
• Wills Eye Optical Three, LLC
• Nicole Elaine Wilson-Carr, PMHNP-BC
• Emily Wilson, PSYD
• Kristina Wilson, LMFT
• Cristina Winchester, BCBA
• Kathleen Winter
• Rachel Wireman/Keller
• Amanda Witherow
• Anne Witman

• Nurse Practitioner in King of Prussia, PA
• Providers in King of Prussia, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.