Individual provider Active NPI

Annalee Martha Wilson, NP

  • Nurse Practitioner
  • Spokane, WA
National Provider Identifier
1760767412
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60249014 Issued in WA
Practice address
6001 N Mayfair St
Spokane, WA 99208-1129
Phone
(855) 229-8012
Fax
(509) 462-2275
NPI assigned
Oct 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60249014 WA Primary
Nurse Practitioner 363L00000X NP-1128A ID
Family Nurse Practitioner 363LF0000X 23519 ID

Addresses

Primary practice location

6001 N Mayfair St
Spokane, WA 99208-1129

Mailing address

5428 E Bridgeport CT
Spokane, WA 99217-7867
Phone (509) 981-3726

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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

Enrollment IDStateProvider typePAC IDDetails
I20111213000818 ID Practitioner - Nurse Practitioner 0345415717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP-1128AIDMDNurse Practitioner
AP60249014WAMDNurse Practitioner
23519IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Oncology Partners, P.a. CurrentSince Aug 18, 2024 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1760767412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5428 E BRIDGEPORT CT",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992177867",
            "telephone_number": "509-981-3726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 N MAYFAIR ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992081129",
            "telephone_number": "855-229-8012",
            "fax_number": "509-462-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ANNALEE",
        "middle_name": "MARTHA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-13",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60249014",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP-1128A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "23519",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.