Individual provider Active NPI

Jerrika Renee Wilkins, LVN

  • Licensed Vocational Nurse
  • Dallas, TX
National Provider Identifier
1972000289
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
191711 Issued in TX
Practice address
13601 Preston Rd Ste 210W
Dallas, TX 75240-4986
Phone
(903) 532-1400
NPI assigned
Apr 12, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 191711 TX Primary

Addresses

Primary practice location

13601 Preston Rd Ste 210W
Dallas, TX 75240-4986

Mailing address

324 Fuller St
Sulphur Springs, TX 75482-2818
Phone (903) 348-4566

Other practice location 1

324 Fuller St
Sulphur Springs, TX 75482-2818
Phone (903) 348-4566

Other identifiers 1

IdentifierTypeStateIssuer
09651516OtherTXDL

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

State licenses

LicenseStateTypeSpecialty
191711TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1972000289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 FULLER ST",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754822818",
            "telephone_number": "903-348-4566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13601 PRESTON RD STE 210W",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752404986",
            "telephone_number": "903-532-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "324 Fuller St",
            "address_purpose": "LOCATION",
            "city": "Sulphur Springs",
            "state": "TX",
            "postal_code": "754822818",
            "country_code": "US",
            "telephone_number": "903-348-4566",
            "fax_number": "903-348-4566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "JERRIKA",
        "middle_name": "RENEE",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "191711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DL",
            "identifier": "09651516",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; 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.