Nicole Edith Wilson, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

POD001284 Issued in GA

Practice address

204 Westside Dr
Douglas, GA 31533-3528

Phone

(912) 384-4121

Fax

(912) 389-1817

NPI assigned

May 25, 2011

Last updated

Feb 25, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Nicole Edith Allen-Wilson Former name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ankle and Foot Assoc LLCGroup PAC ID 1355327107, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Coffee Regional Medical Center, Inc Hospital, Douglas, GA, CCN 110089
• Dorminy Medical Center Hospital, Fitzgerald, GA, CCN 110073

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ankle & Foot Associates, LLC

  • Foot & Ankle Surgery Podiatrist
  • Waycross, GA
  • NPI 1356492599
  Medicare reassignment Care Compare group NPD
• Ankle and Foot Associates, LLC

  • Foot & Ankle Surgery Podiatrist
  • Orange Park, FL
  • NPI 1619444965
  NPD
• Ankle & Foot Associates, LLC

  • Foot & Ankle Surgery Podiatrist
  • Fitzgerald, GA
  • NPI 1801336003
  NPD (past)

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

• Coffee Regional Medical Center, Inc

  dba Coffee Regional Medical Center

  • General Acute Care Hospital
  • Douglas, GA
  • NPI 1760419527
  Care Compare affiliation

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1073806956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 WESTSIDE DR",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315333528",
            "telephone_number": "912-384-4121",
            "fax_number": "912-389-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 WESTSIDE DR",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315333528",
            "telephone_number": "912-384-4121",
            "fax_number": "912-389-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "NICOLE",
        "middle_name": "EDITH",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-25",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD001284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "ALLEN-WILSON",
            "middle_name": "EDITH",
            "prefix": "DR.",
            "credential": "D.P.M.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jodi Maloy Williams, M.ED CCC/SLP
• Laura Williams, NP
• Lisa Williams, M ED CCC/SLP
• Maria Shantae Williams
• Taquoya Williams
• Teresa Lynn Wilson, NP-C
• Jeffery Thomas Winge, M.D.
• Jazmine Woods
• John Gary Wooley II, CRNA
• Monica Nichole Wooten, FNP-C

• Foot & Ankle Surgery Podiatrist in Douglas, GA
• Providers in Douglas, GA by specialty
• Foot & Ankle Surgery Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.