Andy Wilson, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9225092 Issued in FL

Practice address

1375 Roberts Dr
Suite 205
Jacksonville, FL 32250-3210

Phone

(904) 389-1010

Fax

(904) 389-1082

NPI assigned

Aug 27, 2012

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverside Spine and Pain Physicians LLCGroup PAC ID 9931092814, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: andy.wilson.p1@direct.riversidepain.nextgenshare.com
• Direct secure messaging: andy.wilson.1@33498.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Riverside Spine & Pain Physicians, LLC

  • Specialist
  • Jacksonville, FL
  • NPI 1639208648
  Medicare reassignment Care Compare group NPD
• Riverside Spine & Pain Physicians, LLC

  • Specialist
  • Jacksonville, FL
  • NPI 1619343886
  NPD
• Omega Health and Nutrition LLC

  • Nutritionist
  • Jacksonville, FL
  • NPI 1134619208
  NPD (past)
• Riverside Spine Georgia

  • Interventional Pain Medicine Physician
  • Richmond Hill, GA
  • NPI 1942670658
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488240000000",
    "number": "1023366887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6195 LAKE GRAY BLVD",
            "address_2": "SUITE 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445891",
            "telephone_number": "904-389-1010",
            "fax_number": "904-389-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 ROBERTS DR",
            "address_2": "SUITE 205",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322503210",
            "telephone_number": "904-389-1010",
            "fax_number": "904-389-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ANDY",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-27",
        "last_updated": "2017-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9225092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Marie Demus Wilmot, PA
• Tania Anntoinette Wilson-Ocran
• Alyssa Wilson
• Andrea Nicole Wilson, CNP
• Andria Wilson, PT, DPT
• Annette L Wilson, PA-C
• Brandon Wilson, PA-C
• Brook Eden Wilson, APRN-C
• Brooke Wilson
• Chelsea Wilson, BACHELOR LEVEL

• Family Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.