Individual provider Active NPI

Lekia C Wilson, ARNP

  • Family Nurse Practitioner
  • Temple Terrace, FL
National Provider Identifier
1881998540
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9238329 Issued in FL
Practice address
10920 N 56TH St
Temple Terrace, FL 33617-3009
Phone
(813) 922-8724
NPI assigned
Jan 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 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 ARNP9238329 FL Primary

Addresses

Primary practice location

10920 N 56TH St
Temple Terrace, FL 33617-3009

Mailing address

10920 N 56TH St
Temple Terrace, FL 33617-3009
Phone (813) 922-8724

Other practice location 1

2814 14th Ave SE
Ruskin, FL 33570-5471
Phone (813) 349-7800

Other identifiers 1

IdentifierTypeStateIssuer
003123200MedicaidFL

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110201000491 FL Practitioner - Nurse Practitioner 6901085372 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9238329FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc CurrentSince Feb 20, 2019 Accepting new patients
Suncoast Community Health Centers Inc Past Accepting new patients

Locations

12902 Usf Magnolia Dr
Tampa, FL 33612
Phone (813) 745-2720

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": "1294617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1881998540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10920 N 56TH ST",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336173009",
            "telephone_number": "813-922-8724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10920 N 56TH ST",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336173009",
            "telephone_number": "813-922-8724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2814 14th Ave SE",
            "address_purpose": "LOCATION",
            "city": "Ruskin",
            "state": "FL",
            "postal_code": "335705471",
            "country_code": "US",
            "telephone_number": "813-349-7800",
            "fax_number": "813-349-7861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LEKIA",
        "middle_name": "C",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9238329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003123200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.