Individual provider Active NPI

Kayann Wilson

  • Adult Health Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1952371908
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
303712 Issued in NY
Practice address
111 E 210TH St
Bronx, NY 10467-2401
Phone
(718) 920-7738
NPI assigned
Jan 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 303712 NY Primary

Addresses

Primary practice location

111 E 210TH St
Bronx, NY 10467-2401

Mailing address

19 Gettysburg Rd
Southbury, CT 06488-3018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20080508000580 CT Practitioner - Nurse Practitioner 1052325115 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1579 Straits Tpke
Suite E
Middlebury, CT 06762-1841
Phone (860) 714-5824

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003442CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Step Up Care PC LLC CurrentSince Jul 24, 2021 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Apr 17, 2023 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Apr 17, 2023 Accepting new patients
Montefiore Mount Vernon Hospital Past Accepting new patients
Montefiore Medical Center Past Accepting new patients
Montefiore Medical Park Past Accepting new patients
Gun Hill MRI PC Past Accepting new patients

Locations

5 Greenwood St
Hartford, CT 06106
Phone (860) 236-2901

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

1579 Straits Tpke
Ste 2A
Middlebury, CT 06762
Phone (203) 754-3631

1579 Straits Tpke
Ste E
Middlebury, CT 06762
Phone (203) 598-0700

2150 Corbin Ave
New Britain, CT 06053
Phone (860) 223-2761

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

Interoperability endpoints

  • Direct secure messaging: kwilson2998993@direct.trinity-health.org

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1952371908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 GETTYSBURG RD",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064883018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-7738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KAYANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "303712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.