Amanda L Wilson, PEDIATRIC NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

4704264564 Issued in MI

Practice address

358 E Chicago St Ste 202
Coldwater, MI 49036-2073

Phone

(517) 279-5252

NPI assigned

Aug 4, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: awilson313607@direct.promedica.org

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.

• Community Health Center of Branch County

  • General Practice Physician
  • Coldwater, MI
  • NPI 1124055009
  Medicare reassignment NPD
• Community Health Center of Branch County

  • Hematology & Oncology Physician
  • Coldwater, MI
  • NPI 1215964192
  NPD
• Community Health Center of Branch County

  • Internal Medicine Physician
  • Coldwater, MI
  • NPI 1306873286
  NPD
• Community Health Center of Branch County

  • Pediatric Adolescent Medicine Physician
  • Coldwater, MI
  • NPI 1619304458
  NPD
• Regio T Penna MD, PC

  • Specialist
  • Coldwater, MI
  • NPI 1245213537
  NPD
• Icare Pediatrics

  • Pediatrics Physician
  • Okemos, MI
  • NPI 1700519444
  NPD (past)

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1861002883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17444 Q DR N",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490689418",
            "telephone_number": "517-243-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 E CHICAGO ST STE 202",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490362073",
            "telephone_number": "517-279-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "PEDIATRIC NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-04",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704264564",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704264564",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathie E White, DC
• Teresa Ann Whitlock, LMT
• Robbin Sue Wilber, BBA
• Kellie Williams
• Lyndsay Williams
• Haley Alexis Wilson
• Jennifer Wilson
• Sebastian Wilson, DC
• Tamara Winchell, LMSW
• Michelle Marie Winger

• Pediatric Nurse Practitioner in Coldwater, MI
• Providers in Coldwater, MI by specialty
• Pediatric Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.