FONDA MAE WILKINS (NPI# 1649292830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649292830 |
| Entity Type | Individual |
| Full Name | FONDA MAE WILKINS |
| Credential | NP |
| Practice Address |
115 Blarney Dr Columbia SC 29223-6291 |
| Practice Telephone | 8034199091 |
| Practice Fax Number | 8034199199 |
| Mailing Telephone | 8034199091 |
| Mailing Fax Number | 8034199199 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2012-03-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
2964 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LC0200X |
Nurse Practitioner Specialization: Critical Care Medicine |
2964 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NP1257 | 05 | |
| SC | MEDICARE RAILROAD | P00889659 | 01 |
| Street Address |
115 BLARNEY DR |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29223-6291 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790746709 | Reginald L Parker | Emergency Medicine | 115 Blarney Dr, Ste 101, Columbia, SC 29223-6291 | 2006-03-29 |
| 1336684851 | Northlake Family Practice | Exclusive Provider Organization | 115 Blarney Dr, Suite 101 C, Columbia, SC 29223-6291 | 2016-12-20 |
| 1043661986 | Laura E Herbert | Nurse Practitioner | 115 Blarney Dr, Suite 108, Columbia, SC 29223-6291 | 2016-06-22 |
| 1912366527 | Heartfelt Hospice Inc. | Hospice Care, Community Based | 115 Blarney Dr, Suite 204, Columbia, SC 29223-6291 | 2016-02-11 |
| 1689000986 | Hospice Advantage, LLC. | Hospice Care, Community Based | 115 Blarney Dr, Suite 202a, Columbia, SC 29223-6291 | 2013-09-18 |
| 1326488248 | Heartstrings Hospice, LLC | Hospice Care, Community Based | 115 Blarney Dr, Suite 109, Columbia, SC 29223-6291 | 2013-06-25 |
| 1245461391 | Palmetto Health | General Practice | 115 Blarney Dr, Suite 205, Columbia, SC 29223-6291 | 2009-08-06 |
| 1053486050 | Jca Inc | Clinic/Center | 115 Blarney Dr, Columbia, SC 29223-6251 | 2006-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619522794 | Timothy Drew Edwards | Dentist | 122 N. Brickyard Rd, Columbia, SC 29223 | 2019-08-06 |
| 1861983249 | Southern Pain Specialists | Physical Medicine & Rehabilitation | 115 Blarney Dr Ste 111, Columbia, SC 29223 | 2018-05-22 |
| 1710481452 | Evans Counseling and Consulting, LLC | Social Worker | 120 Wildewood Park Dr Ste A, Columbia, SC 29223 | 2018-03-19 |
| 1750824819 | Marquita Heyward | Counselor | 1 Winsor Cove Suite 303, Columbia, SC 29223 | 2016-11-22 |
| 1578015509 | Carolina Family Pharmacy, LLC | Pharmacy | 9153 Two Notch Road, Columbia, SC 29223 | 2016-10-25 |
| 1225485170 | Lisa Diaz | Occupational Therapy Assistant | 7601 Parlane Rd, Columbia, SC 29223 | 2016-05-20 |
| 1295199859 | Sarah Ann Riley | Nurse Practitioner | Cvs Pharmacy 121 Clemson Rd., Columbia, SC 29223 | 2016-04-11 |
| 1134583214 | Sara Alisha Pound | Behavioral Analyst | 97b Winterberry Ln, Columbia, SC 29223 | 2016-04-05 |
| 1508227653 | Lucy Elvira Vicioso-harris | Counselor | 1310 Oakcrest Dr Apt 318, Columbia, SC 29223 | 2016-03-17 |
| 1134585243 | Robin Heaton | Occupational Therapy Assistant | 7601 Parklane Road, Columbia, SC 29223 | 2016-01-05 |
| Find all providers in zip 29223 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043671134 | Abbey Tapler | Nurse Practitioner | 9 Richland Med Pk Dr Ste 450, Columbia, SC 29203-6859 | 2016-03-16 |
| 1528428448 | Mary Frances Snipes | Nurse Practitioner | 3 Richland Medical Park Dr., Suite 310, Columbia, SC 29203-6862 | 2016-03-04 |
| 1841659216 | Lindsey Culbertson Cossio | Nurse Practitioner | 121park Central Drive, Suite 200, Columbia, SC 29203-6476 | 2016-02-15 |
| 1386987634 | Megan L Stanfill | Nurse Practitioner | 915 S Garden St, Columbia, TN 38401 | 2013-04-04 |
| 1699015347 | Farahnaz Nafisy | Nurse Practitioner | 3010 Farrow Rd Ste 300, Columbia, SC 29203-7606 | 2013-02-17 |
| 1114270030 | Rhonda Lamar Gibson | Nurse Practitioner | 147 Fox Squirrel Cir, Columbia, SC 29209-4478 | 2012-10-16 |
| 1952675043 | Charissa Kirkland Lowe | Nurse Practitioner | 1614 Main Street Suite C, Ltc Health Solutions, Columbia, SC 29201-2818 | 2012-03-07 |
| 1467741108 | Ashley L Chapman | Nurse Practitioner | 121 Park Central Dr Ste 200, Columbia, SC 29203-6476 | 2011-04-04 |
| 1629001508 | Carrie A Miller | Nurse Practitioner | 706 Ames Dr, Columbia, MO 65201-7571 | 2006-07-07 |
| 1275591687 | Beckie Merritt Church | Nurse Practitioner | 8 Medical Park Rd, Suite 300, Columbia, SC 29203-6864 | 2006-05-03 |
| Find all providers in COLUMBIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.