MRS. FORRELINE GRIGSBY WILSON (FNP-C) – Family Nurse Practitioner, NPI 1053841759
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MRS. FORRELINE GRIGSBY WILSON (FNP-C)
29610 Rancho California Rd
Temecula, CA 925915283
Phone: (866) 389-2727
Type: Location
511 N HOLLYWOOD WAY
BURBANK, CA 915053406
Phone: (866) 389-2727
Type: Location
1401 S Baldwin Ave
Arcadia, CA 910077922
Phone: (866) 389-2727
Type: Location
5407 COLFAX AVE APT 427
NORTH HOLLYWOOD, CA 916015217
Phone: (704) 726-8437
Type: Mailing
2505, Santa Monica Boulevard, Santa Monica, Los Angeles County, California, 90404, United States
SANTA MONICA, CA 904042011
Phone: (310) 828-6456
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $107.
Total Amount is formed as General ($107) + Research ($0) + Ownership ($0) = $107.
Last reported payment date: 2023-11-12 • Largest payer in this snapshot: Phadia US Inc. ($107).
Total Amount
$107
General + Research + Ownership
Payments
1
Total payment records
General Amount
$107
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Phadia US Inc. | $107 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-07-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170721002559 | I | Nurse Practitioner | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 92591)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IN | |
| - | CA | |
| - | CA | |
| - | NE | |
| - | CA | |
| - | CA | |
| Nurse Practitioner | CA | |
| - | CA | |
| - | CA | |
| - | CA |
Reviews
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