Individual provider Active NPI

Terrie S Wilson, FNP-C

  • Nurse Practitioner
  • Collins, MS
National Provider Identifier
1073334975
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
906643 Issued in MS
Practice address
301 Hospital Blvd
Collins
Collins, MS 39428
Phone
(601) 698-0328
Fax
(601) 765-2808
NPI assigned
Oct 23, 2024
Last updated
Jan 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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 906643 MS Primary

Addresses

Primary practice location

301 Hospital Blvd
Collins
Collins, MS 39428

Mailing address

PO Box 2499
Collins, MS 39428-2499
Phone (601) 765-6711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20250317001218 MS Practitioner - Nurse Practitioner 1052832730 Reassigns benefits to 7 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covington County Hospital CurrentSince Feb 1, 2025 Accepting new patients
Forrest County General Hospital CurrentSince Jul 21, 2025 Accepting new patients
Forest General Dba Highland Community Hospital CurrentSince Jul 21, 2025 Accepting new patients
Covington County Hospital CurrentSince Feb 1, 2025 Accepting new patients
Forrest County General Hospital Current Accepting new patients
Covington County Hospital CurrentSince Feb 1, 2025 Accepting new patients
Covington County Hospital CurrentSince Feb 1, 2025 Accepting new patients
Thomas R. Blackledge, Jr., MD, PA Current Accepting new patients
Covington County Hospital Current Accepting new patients
Covington County Hospital CurrentSince Feb 1, 2025 Accepting new patients
Covington County Hospital CurrentSince Feb 1, 2025 Accepting new patients
Covington County Hospital CurrentSince Feb 1, 2025 Accepting new patients
Green Tree Family Medical Clinic Current Accepting new patients

Locations

3275 Highway 49
Ste E
Collins, MS 39428
Phone (601) 765-6292

701 S Holly Ave
Collins, MS 39428
Phone (601) 765-3180

415 S 28th Ave
Fl 1
Hattiesburg, MS 39401
Phone (601) 288-5200

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

800 3rd St SW
Magee, MS 39111
Phone (601) 849-1918

105 Eaton St
Taylorsville, MS 39168
Phone (601) 452-4280

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/covingc-3983785e

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1729641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1073334975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2499",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "394282499",
            "telephone_number": "601-765-6711",
            "fax_number": "601-698-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL BLVD",
            "address_2": "COLLINS",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "39428",
            "telephone_number": "601-698-0328",
            "fax_number": "601-765-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TERRIE",
        "middle_name": "S",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-23",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "906643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collins, MS

Sources for this page

Verify at the official NPI Registry.