NPIMap

Individual provider Active NPI

Kristen Karol Wilson, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Tempe, AZ
National Provider Identifier
1740451350
Registry record updated Mar 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP2733 Issued in AZ
Practice address
1225 E Broadway Rd
Ste. 240
Tempe, AZ 85282-1525
Phone
(480) 929-5100
Fax
(480) 731-1066
NPI assigned
Mar 23, 2008
Last updated
Mar 23, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP2733 AZ Primary

Addresses

Primary practice location

1225 E Broadway Rd
Ste. 240
Tempe, AZ 85282-1525

Mailing address

1225 E Broadway Rd
Ste. 240
Tempe, AZ 85282-1525
Phone (480) 929-5100

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
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Magellan Health Services of Arizona, Inc Past Accepting new patients
South Central Mental Health Counseling Center, Inc. Past Accepting new patients
Prairie View, Inc. PastSince Aug 1, 1996 Accepting new patients
Magellan Health Services Past Accepting new patients
Magellan Health Services of Arizona, Inc. Past Accepting new patients
South Central Mental Health Counseling Center, Inc. PastSince Dec 3, 2023 Accepting new patients
Prairie View, Inc. Past Accepting new patients

Organizations & group practices 7

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": "1206230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206230400000",
    "number": "1740451350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E BROADWAY RD",
            "address_2": "STE. 240",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852821525",
            "telephone_number": "480-929-5100",
            "fax_number": "480-731-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E BROADWAY RD",
            "address_2": "STE. 240",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852821525",
            "telephone_number": "480-929-5100",
            "fax_number": "480-731-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KRISTEN",
        "middle_name": "KAROL",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-23",
        "last_updated": "2008-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP2733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.

Verify at the official NPI Registry.