Jeremy Lee Wilt, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

28165750A Issued in IN

Practice address

9431 County Road 403
Charlestown, IN 47111-8946

Phone

(812) 256-6391

NPI assigned

Sep 24, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

First Urology PSCGroup PAC ID 3779572888, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Floyd Hospital, New Albany, IN, CCN 150044
• Harrison County Hospital Hospital, Corydon, IN, CCN 151331

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8360/brand/1/csg/1/fhir/r4

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.

• First Urology, PSC

  • Urology Physician
  • Jeffersonville, IN
  • NPI 1922099811

  KY, Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Louisville Geriatric Associates

  • Internal Medicine Physician
  • Jeffersonville, IN
  • NPI 1922337617

  Nurse Practitioner

  Medicare reassignment NPD
• First Urology, PSC

  • Urology Physician
  • Corydon, IN
  • NPI 1235496415

  Nurse Practitioner

  NPD (past)
• Louisville Geriatric Associates

  • Geriatric Medicine (Internal Medicine) Physician
  • Jeffersonville, IN
  • NPI 1871508614

  Nurse Practitioner

  NPD (past)

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

• Baptist Healthcare System, Inc.

  • General Acute Care Hospital
  • New Albany, IN
  • NPI 1497798847
  Care Compare affiliation
• Harrison County Hospital

  • Ambulance
  • Corydon, IN
  • NPI 1073620001

  Hospital

  Care Compare affiliation
• Harrison County Hospital

  • General Acute Care Hospital
  • Corydon, IN
  • NPI 1427165455
  Care Compare affiliation
• Harrison County Hospital

  • Ambulance
  • Corydon, IN
  • NPI 1760599468

  Hospital

  Care Compare affiliation
• Harrison County Hospital

  • Critical Access Hospital
  • Corydon, IN
  • NPI 1851378137
  Care Compare affiliation

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1043689672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9431 COUNTY ROAD 403",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471118946",
            "telephone_number": "812-256-6391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9431 COUNTY ROAD 403",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471118946",
            "telephone_number": "812-256-6391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILT",
        "first_name": "JEREMY",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-24",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71005761A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28165750A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANP CERTIFICATION",
            "identifier": "F0915751",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA LICENSE NUMBER",
            "identifier": "28165750A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Williams
• Bobbi Willis
• Donnie Lee Willis III, LAC, ICAADC
• Robert Cameron Willoughby, PHARMD
• Jami Wilson
• Chelsea Winburn
• Brittany Ann Winsor, APRN
• David Kenneth Wolfe, ATC
• Holly A Woosley, APRN, MSN, FNP-C
• Brittney Wright

• Family Nurse Practitioner in Charlestown, IN
• Providers in Charlestown, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.