Brett M Wilson, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

30000 Issued in TN

Practice address

225 N Willow Ave Ste 3
Cookeville, TN 38501-2453

Phone

(931) 528-8999

Fax

(931) 520-7655

NPI assigned

Sep 25, 2020

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 1

Medicare fee-for-service enrollment

Enrolled in FL, TN2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14267/brand/6/csg/1/fhir/r4
• Direct secure messaging: brett.wilson.1@18192.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.

• Cookeville Medical Center PC

  • Family Medicine Physician
  • Cookeville, TN
  • NPI 1013055912
  Medicare reassignment NPD
• Gulfview Medical Institute PLLC

  • Family Medicine Physician
  • Port Charlotte, FL
  • NPI 1851680789
  Medicare reassignment NPD
• Premier Inpatient Partners LLC

  • Hospitalist Physician
  • Naples, FL
  • NPI 1568916492
  Medicare reassignment NPD
• Wilson Medical Practice NP

  • General Practice Physician
  • Cape Coral, FL
  • NPI 1447849088
  NPD (past) Authorized official
• Upper Cumberland Rural Health Clinic PLLC

  • Rural Health Clinic/Center
  • Sparta, TN
  • NPI 1831994235
  NPD (past)

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1053928804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N WILLOW AVE STE 3",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012453",
            "telephone_number": "931-528-8999",
            "fax_number": "931-520-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N WILLOW AVE STE 3",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012453",
            "telephone_number": "931-528-8999",
            "fax_number": "931-520-7655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 N Willow Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Cookeville",
            "state": "TN",
            "postal_code": "385012453",
            "country_code": "US",
            "telephone_number": "931-528-8899",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "207 E Bockman Way",
            "address_purpose": "LOCATION",
            "city": "Sparta",
            "state": "TN",
            "postal_code": "385832041",
            "country_code": "US",
            "telephone_number": "931-836-6461",
            "fax_number": "833-623-1827",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "229 Interstate Dr Ste 105",
            "address_purpose": "LOCATION",
            "city": "Crossville",
            "state": "TN",
            "postal_code": "385552704",
            "country_code": "US",
            "telephone_number": "931-250-5230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRETT",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-25",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11009348",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "30000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q079333",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robyn Lynn Willis, L.P.C.
• Elizabeth Kay Elsea Wilmore, PA-C
• Kasandra Kay Wilmore, CCRN
• Lisa Wilmoth, MA
• Bradford Taylor Wilson
• Carolyn Wilson, BCBA
• Carylon Wilson
• Emily Wilson
• Hailey Mariah Wilson
• Jennifer Jo Wilson, LMT

• Family Nurse Practitioner in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.