Individual provider Active NPI

Amber F Wilkinson, APN

  • Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1053535211
Registry record updated Mar 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
12663 Issued in TN
Practice address
2685 Boones Creek Road
Suite 104
Johnson City, TN 37615
Phone
(423) 282-0636
Fax
(423) 282-1990
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2011

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 12663 TN Primary

Addresses

Primary practice location

2685 Boones Creek Road
Suite 104
Johnson City, TN 37615

Mailing address

2685 Boones Creek Road
Suite 104
Johnson City, TN 37615
Phone (423) 282-0636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20070710000963 TN Practitioner - Nurse Practitioner 7214037902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boones Creek Medical PLLCGroup PAC ID 6507969631, 3 clinicians

Practice addresses (Care Compare)

1000 W Jackson Blvd
Suite 5 6
Jonesborough, TN 37659-5397
Phone 4232820636803

Hospital & facility affiliations

  • Greeneville Community Hospital Hospital, Greeneville, TN, CCN 440050
  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063
  • Franklin Woods Community Hospital Hospital, Johnson City, TN, CCN 440184

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Boones Creek Medical PLLC CurrentSince Apr 1, 2007 Accepting new patients
Johnson City Emergency Physicians, PC Nurse Practitioner Past Accepting new patients
Wellmont Physician Services Inc Nurse Practitioner Past Accepting new patients

Locations

1000 W Jackson Blvd
Ste 5
Jonesborough, TN 37659
Phone (423) 753-7070

1000 W Jackson Blvd
Ste 56
Jonesborough, TN 37659
Phone (423) 282-0636

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14317/brand/1/csg/1/fhir/r4
  • Direct secure messaging: amber.wilkinson.1@14317.direct.athenahealth.com

Organizations & group practices 3

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 5

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299196800000",
    "number": "1053535211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2685 BOONES CREEK ROAD",
            "address_2": "SUITE 104",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37615",
            "telephone_number": "423-282-0636",
            "fax_number": "423-282-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2685 BOONES CREEK ROAD",
            "address_2": "SUITE 104",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37615",
            "telephone_number": "423-282-0636",
            "fax_number": "423-282-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "AMBER",
        "middle_name": "F",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2011-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "12663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.