Kristen Mabus Wilson, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

20205 Issued in SC

Practice address

380 Serpentine Dr
Suite 200
Spartanburg, SC 29303-3066

Phone

(864) 560-7050

Fax

(864) 560-0800

NPI assigned

Nov 20, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spartanburg Medical Center Hospital, Spartanburg, SC, CCN 420007
• Pelham Medical Center Hospital, Greer, SC, CCN 420103

Merit-based Incentive Payment System (MIPS)

Final score

94.7 of 100Reported as apm

Quality

89.4

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

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.

• Spartanburg Medical Center

  • Neuromusculoskeletal Medicine & OMM Physician
  • Spartanburg, SC
  • NPI 1043309917
  Medicare reassignment Care Compare group NPD
• Spartanburg Medical Center

  • Hematology & Oncology Physician
  • Spartanburg, SC
  • NPI 1013161520
  NPD
• Spartanburg Medical Center

  • Physical Medicine & Rehabilitation Physician
  • Spartanburg, SC
  • NPI 1942188875
  NPD
• Spartanburg Medical Center

  • Obstetrics & Gynecology Physician
  • Spartanburg, SC
  • NPI 1376580852
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pelham Medical Center

  • Pain Medicine Physician
  • Greer, SC
  • NPI 1942960844

  Hospital

  Care Compare affiliation
• Pelham Medical Center

  • General Acute Care Hospital
  • Greer, SC
  • NPI 1982800397
  Care Compare affiliation
• Spartanburg Medical Center

  • Psychiatric Hospital Unit
  • Spartanburg, SC
  • NPI 1033681630
  Care Compare affiliation
• Spartanburg Medical Center

  • Family Medicine Physician
  • Spartanburg, SC
  • NPI 1326373697

  Hospital

  Care Compare affiliation
• Spartanburg Medical Center

  • General Acute Care Hospital
  • Spartanburg, SC
  • NPI 1609807122
  Care Compare affiliation
• Spartanburg Medical Center

  • Rehabilitation Hospital Unit
  • Spartanburg, SC
  • NPI 1942772546
  Care Compare affiliation

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

{
    "created_epoch": "1321747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1831466747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 SERPENTINE DR",
            "address_2": "SUITE 200",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033066",
            "telephone_number": "864-560-7050",
            "fax_number": "864-560-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KRISTEN",
        "middle_name": "MABUS",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-20",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA 15085 NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "207724",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "TL20205",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7005571",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1954",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwilson72096@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kwilson72096@direct-srhs.et0939.epichosted.com",
            "address_1": "380 Serpentine Dr",
            "address_2": "SUITE 200",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293033066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Janet Leahy Wilson, PA-C
• Janet Monaco Wilson, O.D.
• John Roger Wilson III, CRNA
• Kelly Martin Wilson, PA-C
• Kimberly Susann Wilson, APRN
• Margaret Elizabeth Wilson, LPC
• Maria Wilson, PT
• Paula F Wilson, BA, CAC-P
• Paula J Wilson, RN
• Seng Silapheth Wilson, CRNA

• Family Nurse Practitioner in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.