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BONITA SPRINGS FAMILY PRACTICE CENTER
NPI 1497938963
General Practice in Estero, FL

Active since December 07, 2007CLIA 10D1069097 · Waiver
10201 ARCOS AVE SUITE 202, ESTERO, FL 33928(239) 949-1212(239) 949-0587 Get Directions Write a Review

NPPES record last updated: November 20, 2013. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Bonita Springs Family Practice Center NPPES

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

BONITA SPRINGS FAMILY PRACTICE CENTER (NPI 1497938963) is a healthcare organization registered as a general practice in Estero, Florida and active in the NPI registry since December 2007. The organization holds a CLIA Waiver certificate valid through May 28, 2027 and lists Richard R Wilson, Doctor/owner, as its authorized official.

NPPES Registry Identity

NPI1497938963
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameRICHARD R. WILSON, D.O.
Location Address10201 ARCOS AVE SUITE 202Estero, FL 33928
Mailing Address10201 Arcos Ave Suite 202Estero, FL 33928 · (239) 949-1212 · Fax (239) 949-0587
Phone(239) 949-1212
Fax(239) 949-0587
Organization SubpartNo
Authorized OfficialRichard R WilsonDoctor/owner · (239) 949-1212
Enumeration DateDecember 7, 2007
Last NPPES UpdateNovember 20, 2013
✔ NPI 1497938963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in FL · OS9100
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
10201 ARCOS AVE SUITE 202, Estero, FL 33928
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Other Names 1

Doing Business AsBonita Springs Family Practice Center

Other Identifiers 1

Medicare PIN37396ZFL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bonita Springs Family Practice Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Bonita Springs Family Practice Center, which bills Medicare for the services this clinician delivers.

Clinician (1)

Richard Wilson, D.O.
Family Practice
NPI 1528021417
9250 CORKSCREW RD STE 5
Estero, FL 33928
(239) 949-1212
✔ PECOS✔ Accepts Medicare0.9 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1069097

Richard R Wilson Do · Estero, FL
Active · expires May 28, 2027
CLIA Number10D1069097
Laboratory TypePhysician Office
Certificate Effective DateMay 29, 2025
Certificate Expiration DateMay 28, 2027
Laboratory DirectorRichard R. Wilson Do
Laboratory Phone(239) 949-1212
Laboratory LocationRichard R Wilson Do9250 Corkscrew Rd Ste 5, Estero, FL 33928
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Richard R. Wilson, D.O.'s NPI number?

The NPI number for Richard R. Wilson, D.O. is 1497938963. It was assigned to this organization in the NPPES registry on December 7, 2007. The provider is doing business as Bonita Springs Family Practice Center.

Where is Richard R. Wilson, D.O. located?

Richard R. Wilson, D.O. is located at 10201 Arcos Ave Suite 202, Estero, FL 33928. The listed phone number is (239) 949-1212.

What is Richard R. Wilson, D.O.'s specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Richard R. Wilson, D.O. enrolled in Medicare?

Yes. Richard R. Wilson, D.O. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Richard R. Wilson, D.O.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Richard R. Wilson, D.O.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Richard R. Wilson, D.O. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1069097) is associated with this NPI, valid through May 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Richard R. Wilson, D.O. was last updated on November 20, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.