Willa Carson Health and Wellness Center

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

WILLA CARSON HEALTH AND WELLNESS CENTER

Practice address

1108 N Martin Luther King Jr Ave
Clearwater, FL 33755-3222

Phone

(727) 467-9411

Fax

(727) 467-2771

NPI assigned

Sep 28, 2011

Organization subpart

No

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

Authorized official

Name

Annie Tyrell, RN

Title

Executive Director

Phone

(727) 467-9411

Specialties & licenses 1

Addresses

Tax ID family

Willa Carson Health and Wellness Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Willa Carson Health Resource Center

  • Clinic/Center
  • Clearwater, FL
  • NPI 1821320383
  NPD tax ID

Locations

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

{
    "created_epoch": "1317168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317168000000",
    "number": "1902180789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 N MARTIN LUTHER KING JR AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337553222",
            "telephone_number": "727-467-9411",
            "fax_number": "727-467-2771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 N MARTIN LUTHER KING JR AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337553222",
            "telephone_number": "727-467-9411",
            "fax_number": "727-467-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLA CARSON HEALTH AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-28",
        "last_updated": "2011-09-28",
        "status": "A",
        "authorized_official_last_name": "TYRELL",
        "authorized_official_first_name": "ANNIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "727-467-9411",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Patrick Wiles, HSC
• Lourdes M Wilhelm, BS
• Elena Wilkinson
• Eric James Wilkinson, P.T.
• Margaret Kay Wilkinson, RPH
• Willa Carson Health Resource Center
• Cindylee Willard, A.R.N.P.
• Desiree Willever
• Ronald R Willey, M.D.
• William C Brown M D Inc

• General Practice Physician in Clearwater, FL
• Providers in Clearwater, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.