Active NPI
Cindy Ann Wilson, CPNP
- Pediatric Nurse Practitioner
- Philadelphia, PA
National Provider Identifier
1740448190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- SP004727D
- Practice address
- 3509 N Broad St
Philadelphia, PA 19140-4105 - Phone
- (215) 707-5437
- Fax
- (215) 707-5180
- NPI assigned
- May 31, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | SP004727D | PA | Primary |
Addresses
Primary practice location
3509 N Broad St
Philadelphia, PA 19140-4105
Mailing address
3509 N Broad St
Philadelphia, PA 19140-4105
Phone (215) 707-5437
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)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Temple Faculty Practice Plan Inc | Past | Accepting new patients |
Interoperability endpoints
- cwilson2019938@direct.trinity-health.org
Organizations & group practices 1
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.
-
- Dermatology Physician
- Philadelphia, PA
- NPI 1285116228
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212192000000",
"number": "1740448190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3509 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191404105",
"telephone_number": "215-707-5437",
"fax_number": "215-707-5180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3509 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191404105",
"telephone_number": "215-707-5437",
"fax_number": "215-707-5180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CINDY",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-31",
"last_updated": "2008-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "PA",
"license": "SP004727D",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.