Active NPI
Katie L Wilkerson, ARNP
- Nurse Practitioner
- Palm Bay, FL
National Provider Identifier
1891855532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- ARNP 3073572
- Practice address
- 20 San Filippo Dr SE
Palm Bay, FL 32909-2200 - Phone
- (321) 725-8300
- Fax
- (321) 725-1555
- NPI assigned
- Dec 11, 2006
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP 3073572 | FL | Primary |
Addresses
Primary practice location
20 San Filippo Dr SE
Palm Bay, FL 32909-2200
Mailing address
PO Box 534595
Atlanta, GA 30353-4595
Phone (800) 331-9294
Other practice location 1
1048 Harvin Way
Rockledge, FL 32955-3229
Phone (321) 636-2111
Other practice location 2
1264 Malabar Rd SE
Palm Bay, FL 32907
Phone (321) 725-8300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 308812000 | Medicaid | FL |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP 3073572 | FL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618876800000",
"number": "1891855532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 534595",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303534595",
"telephone_number": "800-331-9294",
"fax_number": "812-962-6425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 SAN FILIPPO DR SE",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329092200",
"telephone_number": "321-725-8300",
"fax_number": "321-725-1555"
}
],
"practiceLocations": [
{
"address_1": "1048 Harvin Way",
"address_purpose": "LOCATION",
"city": "Rockledge",
"state": "FL",
"postal_code": "329553229",
"country_code": "US",
"telephone_number": "321-636-2111",
"fax_number": "321-636-7180",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1264 Malabar Rd SE",
"address_purpose": "LOCATION",
"city": "Palm Bay",
"state": "FL",
"postal_code": "32907",
"country_code": "US",
"telephone_number": "321-725-8300",
"fax_number": "321-725-1555",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILKERSON",
"first_name": "KATIE",
"middle_name": "L",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-11",
"last_updated": "2021-04-20",
"certification_date": "2021-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP 3073572",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "308812000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palm Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.