Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Michael Todd Wilkerson, FNP-C

Individual provider Family Nurse Practitioner · NPI 1629450457

Michael Todd Wilkerson, FNP-C is a Nurse Practitioner in Johnson City, Tennessee. Qualified in 2014, 12 years ago. Practices with Revida Recovery Centers PC, a 29-clinician group. Licensed in Tennessee.

Years since qualifying
12
Licensed in
TN
In the registry since
2015
Specialties on file
2
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

3114 Browns Mill Rd
Johnson City, TN 37604-1417
Phone: (423) 631-0432
Fax: (423) 232-8818
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 19438 (TN)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence APN0000019438 (TN)

Record details

NPI number1629450457
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedJune 29, 2015
Last updated in NPPESFebruary 25, 2026
Certification dateFebruary 25, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Revida Recovery Centers Pc — 29 clinicians
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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