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MS. TINY BENITA WILSON FNP
NPI 1417029133
Nurse Practitioner - Family in Conyers, GA

Active since November 15, 2006PECOS Enrolled
2890 GEORGIA HIGHWAY 212 SW STE A360, CONYERS, GA 30094(770) 601-6892 Get Directions Write a Review

NPPES record last updated: June 20, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ms. Tiny Benita Wilson Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. TINY BENITA WILSON FNP (NPI 1417029133) is an individual family provider in Conyers, Georgia, licensed in Georgia (RN135948NP) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417029133
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMS. TINY BENITA WILSONCredential: FNP
Location Address2890 GEORGIA HIGHWAY 212 SW STE A360Conyers, GA 30094
Mailing Address2890 Georgia Highway 212 Sw Ste A360Conyers, GA 30094-3363 · (770) 601-6892
Phone(770) 601-6892
Sole ProprietorNo
Enumeration DateNovember 15, 2006
Last NPPES UpdateJune 20, 2018
✔ NPI 1417029133 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in GA · RN135948NP
2890 GEORGIA HIGHWAY 212 SW STE A360, Conyers, GA 30094
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Tiny Benita Wilson Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30094 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tiny Wilson's NPI number?

The NPI number for Tiny Wilson is 1417029133. It was assigned to this individual provider in the NPPES registry on November 15, 2006.

Where is Tiny Wilson located?

Tiny Wilson practices at 2890 Georgia Highway 212 SW Ste A360, Conyers, GA 30094. The listed phone number is (770) 601-6892.

What is Tiny Wilson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Tiny Wilson enrolled in Medicare?

Yes. Tiny Wilson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tiny Wilson was last updated on June 20, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.