Individual provider Active NPI

Linda M. Wilson, M.D.

  • Obstetrics & Gynecology Physician
  • Brandon, FL
National Provider Identifier
1861463861
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME118638 Issued in FL
Practice address
116 Parsons Park Dr
Brandon, FL 33511-6066
Phone
(813) 681-6625
Fax
(813) 684-6043
NPI assigned
Jan 28, 2006
Last updated
Oct 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME118638 FL Primary
Obstetrics & Gynecology Physician 207V00000X MD026147E PA

Addresses

Primary practice location

116 Parsons Park Dr
Brandon, FL 33511-6066

Mailing address

PO Box 25317
Tampa, FL 33622-5317
Phone (813) 286-0033

Other identifiers 3

IdentifierTypeStateIssuer
000866973MedicaidPA
232359401OtherPAMAIN LINE HEALTHCARE
012103000MedicaidFL

Other names 1

  • Linda Cassel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140722002645 FL Practitioner - Obstetrics/Gynecology 9133312994 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Care Florida LLC Obstetrics & Gynecology CurrentSince Aug 1, 2014 Accepting new patients

Locations

116 Parsons Park Dr
Brandon, FL 33511
Phone (813) 681-6625

13149 Elk Mountain Dr
Riverview, FL 33579
Phone (813) 467-4870

2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1861463861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25317",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336225317",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 PARSONS PARK DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116066",
            "telephone_number": "813-681-6625",
            "fax_number": "813-684-6043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LINDA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-28",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME118638",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD026147E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000866973",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAIN LINE HEALTHCARE",
            "identifier": "232359401",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012103000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "CASSEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.