Individual provider Active NPI

Gina Marie Wilson, ARNP

  • Family Nurse Practitioner
  • Durham, NC
National Provider Identifier
1831572734
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
244366 Issued in NC
Practice address
1301 Fayetteville St
Durham, NC 27707-2325
Phone
(919) 956-4000
Fax
(904) 249-3371
NPI assigned
Jul 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 244366 NC Primary

Addresses

Primary practice location

1301 Fayetteville St
Durham, NC 27707-2325

Mailing address

1301 Fayetteville St
Durham, NC 27707-2325
Phone (919) 956-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20170510000343 NC Practitioner - Nurse Practitioner 1951688480 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln Community Health Center Incorporated CurrentSince Apr 17, 2017 Accepting new patients
Lincoln Community Health Center Incorporated CurrentSince Apr 17, 2017 Accepting new patients

Locations

1301 Fayetteville St
Durham, NC 27707
Phone (919) 956-4000

Organizations & group practices 2

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": "1436400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1831572734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 FAYETTEVILLE ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072325",
            "telephone_number": "919-956-4000",
            "fax_number": "919-667-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 FAYETTEVILLE ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072325",
            "telephone_number": "919-956-4000",
            "fax_number": "904-249-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-09",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "244366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.