DORTHIA D WILSON NP NPI 1669838496

NPI Information

  • NPI: 1669838496
  • Provider Name: DORTHIA D WILSON, NP
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 530 NE GLEN OAK AVE
    PEORIA, IL
    ZIP 61637
  • Phone: (309) 624-8820

Map and Directions

Get Directions

NPI Details

Dorthia D Wilson, NP is a primary care nurse practitioner in Peoria, IL with 10 years of experience. Dorthia D Wilson, NP NPI is 1669838496. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

530 NE GLEN OAK AVE
PEORIA, IL
ZIP 61637-001
Phone: (309) 624-8820
Fax: (309) 624-8820

The NPI 1669838496 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Extended patient service without direct patient contact, first hour (HCPCS:99358)
  • Advance care planning, first 30 minutes (HCPCS:99497)
  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Initial hospital inpatient care per day, typically 30 minutes (HCPCS:99221)
  • Initial hospital inpatient care per day, typically 70 minutes (HCPCS:99223)
  • Follow-up hospital inpatient care per day, typically 35 minutes (HCPCS:99233)

The enumeration date for this NPI number is 1/9/2016 and was last updated on 12/18/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse Practitioner6647WISCONSINNo
2363LP2300XNurse PractitionerPrimary Care209030955ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1100054093MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI