Rachael Leeann Wilson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.006457 Issued in OH

Practice address

2043 College Way
Forest Grove, OR 97116-1756

Phone

(503) 352-6151

NPI assigned

Jul 30, 2018

Last updated

Jan 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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 OH

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Ohio Hospitalists, IncGroup PAC ID 7810985686, 194 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Central Ohio Hospitalists, Inc

  • Specialist
  • Columbus, OH
  • NPI 1659455145
  Medicare reassignment Care Compare group NPD
• Mount Carmel Health System

  dba Mount Carmel Health System Physicians

  • Internal Medicine Physician
  • Columbus, OH
  • NPI 1457617235
  Medicare reassignment NPD
• Pai Participant 1 LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Chillicothe, OH
  • NPI 1093371312

  Physician Assistant

  Medicare reassignment NPD
• Premier Health Specialists Inc

  • Internal Medicine Physician
  • Moraine, OH
  • NPI 1194958223
  Medicare reassignment
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  OH

  Medicare reassignment
• Mount Carmel Health System

  dba Mount Carmel Dublin

  • General Acute Care Hospital
  • Dublin, OH
  • NPI 1710752183
  NPD
• Premier Health Specialists Inc

  dba Premier OBGyn

  • Obstetrics & Gynecology Physician
  • Springboro, OH
  • NPI 1558667261
  NPD
• Premier Health Specialists Inc

  dba Advanced Ankle and Foot Specialists

  • Foot & Ankle Surgery Podiatrist
  • Dayton, OH
  • NPI 1902211287
  NPD

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1083192488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 KETTERING BLVD",
            "address_2": "BUILDING B 3RD FLOOR",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391924",
            "telephone_number": "937-991-3188",
            "fax_number": "937-223-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 COLLEGE WAY",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161756",
            "telephone_number": "503-352-6151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 M.L.K. Way",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "98405",
            "country_code": "US",
            "telephone_number": "253-406-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "RACHAEL",
        "middle_name": "LEEANN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006457",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE LISENCE",
            "identifier": "PA60890324",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tonnie Irene White, LMT
• Deborah Elaine Johnson Williams, O.D.
• Irene Mary Willison, RN
• Noah Wilson-Fey
• Paul Wilson, PT
• Evan Wollen, O.D.
• Eva Wai-Man Wong
• King Cheong Brian Wong, DDS
• Eric Brian Woods, L.M.T.
• Jennifer Nicole Wustenberg, RDH

• Physician Assistant in Forest Grove, OR
• Providers in Forest Grove, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.