Ms Tiny Benita Wilson, FNP in Conyers, GA - Medicare Nurse Practitioner

Ms Tiny Benita Wilson, FNP is a medicare enrolled "Nurse Practitioner - Family" in Conyers, Georgia. Her current practice location is 2890 Georgia Highway 212 Sw Ste A360, Conyers, Georgia. You can reach out to her office (for appointments etc.) via phone at (770) 601-6892.

Ms Tiny Benita Wilson is licensed to practice in Georgia (license number RN135948NP) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1417029133.

Contact Information

	Ms Tiny Benita Wilson, FNP
	2890 Georgia Highway 212 Sw Ste A360, Conyers, GA 30094
	(770) 601-6892
	Not Available

Map and Direction

Provider's Profile

Full Name	Ms Tiny Benita Wilson
Gender	Female
Speciality	Nurse Practitioner - Family
Location	2890 Georgia Highway 212 Sw Ste A360, Conyers, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1417029133
Provider Enumeration Date: 11/15/2006
Last Update Date: 06/20/2018

Medicare PECOS Information:

PECOS PAC ID: 2668609322
Enrollment ID: I20190109002833

Medical Identifiers

Medical identifiers for Ms Tiny Benita Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1417029133	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	RN135948NP (Georgia)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Tiny Benita Wilson allows following entities to bill medicare on her behalf.

Entity Name	North Sonoma County Health Care District
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1194824573 PECOS PAC ID: 4789594367 Enrollment ID: O20060406000251

Entity Name	Norcal Healthconnect Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1720695547 PECOS PAC ID: 2466864038 Enrollment ID: O20210308001127

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Tiny Benita Wilson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Ms Tiny Benita Wilson, FNP 2890 Georgia Highway 212 Sw Ste A360, Conyers, GA 30094-3363 Ph: (770) 601-6892	Ms Tiny Benita Wilson, FNP 2890 Georgia Highway 212 Sw Ste A360, Conyers, GA 30094 Ph: (770) 601-6892

Reviews and Comments

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Meetali Bindra, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1288 Wellbrook Cir Ne Ste A, Conyers, GA 30012 Phone: 678-369-6934
Ms. Judith T Chabot, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 425 Sigman Rd Nw, Suite 109, Conyers, GA 30012 Phone: 678-413-2026 Fax: 678-413-2030
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Ms Tiny Benita Wilson, FNP - Medicare Nurse Practitioner in Conyers, GA