Active NPI
Kathryn Ann Wilk, CPNP
- Pediatric Nurse Practitioner
- Boston, MA
National Provider Identifier
1881841385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 274122
- Practice address
- 1153 Centre St
Suite 31
Boston, MA 02130-3446 - Phone
- (617) 522-3100
- NPI assigned
- Aug 26, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 274122 | MA | Primary |
Addresses
Primary practice location
1153 Centre St
Suite 31
Boston, MA 02130-3446
Mailing address
1153 Centre St
Suite 31
Boston, MA 02130-3446
Phone (617) 522-3100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Pediatric Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 274122 | MA | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219708800000",
"number": "1881841385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1153 CENTRE ST",
"address_2": "SUITE 31",
"city": "BOSTON",
"state": "MA",
"postal_code": "021303446",
"telephone_number": "617-522-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1153 CENTRE ST",
"address_2": "SUITE 31",
"city": "BOSTON",
"state": "MA",
"postal_code": "021303446",
"telephone_number": "617-522-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILK",
"first_name": "KATHRYN",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-26",
"last_updated": "2008-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MA",
"license": "274122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.