Margot Veronica Wilson, NURSE PRACTITIONER
Individual provider Active NPI Nurse Practitioner · Tucson, AZ
NPI 1780945469 · NPPES record last updated Mar 20, 2024
Key facts
- NPI
- 1780945469
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 0024170754 (VA)
- Practice address
- 1625 W Ina Rd Ste 123
Tucson, AZ 85704-1975 - Phone
- (520) 297-9813
- NPI assigned
- May 30, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Western Tidewater Community Mental
Practice addresses (Care Compare)
7025 Harbour View Blvd
Suite 119
Suffolk, VA 23435-2762
Phone (757) 966-2805
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160624000217 | VA | Practitioner - Nurse Practitioner | 7315194990 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024170754 | VA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tidewater Medspa PLLC | Current | Accepting new patients | |
| 1St Option Home Healthcare Services,LLC | Current | Accepting new patients | |
| Western Tidewater Community Mental | Current |
Accepting new patients | |
| Serene Home Care Services, LLC | Current | Accepting new patients | |
| Alif Sarah, MD PC | Past |
Accepting new patients |
Locations
200 E 2nd Ave
Franklin, VA 23851
Phone (757) 562-2208
1913 S Church St
Ste 2
Smithfield, VA 23430
Phone (757) 357-7458
1000 Commercial Ln
Suffolk, VA 23434
Phone (757) 925-2484
7025 Harbour View Blvd
Ste 119
Suffolk, VA 23435
Phone (757) 670-7471
5268 Godwin Blvd
Suffolk, VA 23434
Phone (757) 255-7117
135 S Saratoga St
Suffolk, VA 23434
Phone (757) 925-1981
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 0024170754 | VA | Yes |
Addresses
Primary practice location
1625 W Ina Rd Ste 123
Tucson, AZ 85704-1975
Mailing address
1648 W Blue Horizon St
Tucson, AZ 85704-1445
Phone (757) 617-3850
Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.