Individual provider Active NPI

John J Wilcox, FNP

  • Nurse Practitioner
  • Wasilla, AK
National Provider Identifier
1053190413
Registry record updated Oct 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
243405 Issued in AK
Practice address
3505 E Meridian Park Loop
Wasilla, AK 99654-7242
Phone
(907) 416-6594
Fax
(800) 654-6250
NPI assigned
Sep 25, 2023
Last updated
Oct 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 243405 AK Primary

Addresses

Primary practice location

3505 E Meridian Park Loop
Wasilla, AK 99654-7242

Mailing address

3505 E Meridian Park Loop
Wasilla, AK 99654-7242
Phone (907) 416-6594

Other practice location 1

4000 Old Seward Hwy Ste 301
Anchorage, AK 99503-6068
Phone (907) 416-6594

Other practice location 2

1405 Kellum St Ste 100
Fairbanks, AK 99701-4189
Phone (907) 416-6594

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, AK2 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

Enrollment IDStateProvider typePAC IDDetails
I20240517000386 OR Practitioner - Nurse Practitioner 8325489685 Reassigns benefits to 1 organization
I20260106001614 AK Practitioner - Nurse Practitioner 8325489685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Northern Neurology LLCGroup PAC ID 6204377435, 4 clinicians

Practice addresses (Care Compare)

10928 Eagle River Rd
Eagle River, AK 99577-8078
Phone (907) 694-8085

1700 E Bogard Rd
Wasilla, AK 99654-6570
Phone (907) 921-5088

3505 E Meridian Park Loop
Suite 100
Wasilla, AK 99654-7242
Phone (855) 431-8555

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
243405AKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicops, LLC Family CurrentSince Apr 1, 2024 Accepting new patients
Northern Neurology, LLC CurrentSince Dec 1, 2025 Accepting new patients
Clinicops LLC CurrentSince May 25, 2025 Accepting new patients
Clinicops LLC PastSince May 25, 2025 Accepting new patients
Clinicops LLC Family PastSince May 25, 2025 Accepting new patients

Locations

4000 Old Seward Hwy
Ste 301
Anchorage, AK 99503
Phone (907) 416-6594

1405 Kellum St
Fairbanks, AK 99701
Phone (855) 431-8555

1405 Kellum St
Ste 100
Fairbanks, AK 99701
Phone (907) 416-6594

3505 E Meridian Park Loop
Ste 100
Wasilla, AK 99654
Phone (907) 357-4963

3 River Ave
Eugene, OR 97404

2970 Highway 101
Florence, OR 97439
Phone (541) 902-0800

2459 SE Tualatin Valley Hwy
Hillsboro, OR 97123
Phone (971) 275-8783

923 NW 14th Ave
Portland, OR 97209

374 Owens St SE
Salem, OR 97302
Phone (503) 399-1400

Interoperability endpoints

  • Direct secure messaging: john.wilcox.1@32746.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791504000000",
    "number": "1053190413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 E MERIDIAN PARK LOOP",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547242",
            "telephone_number": "907-416-6594",
            "fax_number": "800-654-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 E MERIDIAN PARK LOOP",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547242",
            "telephone_number": "907-416-6594",
            "fax_number": "800-654-6250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Old Seward Hwy Ste 301",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995036068",
            "country_code": "US",
            "telephone_number": "907-416-6594",
            "fax_number": "800-654-6250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1405 Kellum St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fairbanks",
            "state": "AK",
            "postal_code": "997014189",
            "country_code": "US",
            "telephone_number": "907-416-6594",
            "fax_number": "800-654-6250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-25",
        "last_updated": "2026-10-09",
        "certification_date": "2026-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AK",
            "license": "243405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.