Individual provider Active NPI

Whitney Wilson, NP-C

  • Family Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1043840812
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28254236A Issued in IN
Practice address
3700 Washington Ave # 2200
Evansville, IN 47714-0541
Phone
(812) 485-7111
NPI assigned
Jan 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28254236A IN Primary

Addresses

Primary practice location

3700 Washington Ave # 2200
Evansville, IN 47714-0541

Mailing address

3700 Washington Ave # 2200
Evansville, IN 47714-0541
Phone (989) 860-8532

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address whitney.wilson.1@7598.direct.athenahealth.com St Mary's Medical Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20200320001656 IN Practitioner - Nurse Practitioner 6709214927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians

Practice addresses (Care Compare)

3700 Washington Ave
Suite 2200
Evansville, IN 47714-0541
Phone (812) 485-7111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28254236AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary'S Medical Group, LLC Family CurrentSince Feb 2, 2020 Accepting new patients
St. Mary'S Physician Network LLC. Family CurrentSince May 22, 2022 Accepting new patients
St Mary'S Medical Group, LLC CurrentSince Feb 2, 2020 Accepting new patients
St. Mary'S Health, Inc Past Accepting new patients
St Vincent Physician Services Hospital and Health Care Center PastSince May 22, 2022 Accepting new patients

Locations

3700 Washington Ave
#2200
Evansville, IN 47714
Phone (812) 485-7111

14020 Old State Rd
Ste C200
Evansville, IN 47725
Phone (812) 469-4700

516 Court St
#A
Evansville, IN 47708
Phone (812) 485-2100

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

100 S Rosenberger Ave
Ste B300
Evansville, IN 47712
Phone (812) 485-7111

3700 Washington Ave
Ste 2200
Evansville, IN 47714
Phone (812) 485-7111

801 Saint Marys Dr
Ste 505E
Evansville, IN 47714
Phone (812) 491-3236

Interoperability endpoints

  • Direct secure messaging: whitney.wilson.1@7598.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1043840812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON AVE # 2200",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140541",
            "telephone_number": "989-860-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON AVE # 2200",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140541",
            "telephone_number": "812-485-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "WHITNEY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-21",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28254236A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "whitney.wilson.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "3700 Washington Ave # 2200",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477140541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.