NPIMap

Individual provider Active NPI

Jessica Lynn Wilson, MSN FNP-BC

  • Family Nurse Practitioner
  • Hale, MI
National Provider Identifier
1083950976
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704227052 Issued in MI
Practice address
436 W Main St
Hale, MI 48739-9246
Phone
(989) 892-7722
NPI assigned
Dec 20, 2012
Last updated
Oct 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704227052 MI Primary

Addresses

Primary practice location

436 W Main St
Hale, MI 48739-9246

Mailing address

436 W Main St
Hale, MI 48739-9246

Other identifiers 1

IdentifierTypeStateIssuer
1083950976MedicaidMI

Other names 1

  • Mrs. Jessica Lynn Spencer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150119000536 MI Practitioner - Nurse Practitioner 8628392867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Saginaw Valley Medical College - NLG, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progress Physical Therapy IncGroup PAC ID 5698669919, 23 clinicians
Sterling Area Health CenterGroup PAC ID 3577560846, 20 clinicians

Practice addresses (Care Compare)

3076 Northridge Rd
Hale, MI 48739-9277
Phone (989) 728-0242

436 W Main St
Hale Clinic
Hale, MI 48739-9246
Phone (989) 728-2800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704227052MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Area Health Center CurrentSince Sep 12, 2020 Accepting new patients
Sterling Area Health Center Current Accepting new patients
Sterling Area Health Center CurrentSince Sep 12, 2020 Accepting new patients
Sterling Area Health Center Past Accepting new patients
Sterling Area Health Center Past Accepting new patients
Sterling Area Health Center Past Accepting new patients

Locations

436 W Main St
Hale, MI 48739
Phone (989) 728-2800

1827 Greenwood Rd
Prescott, MI 48756
Phone (989) 873-6200

725 E State St
Sterling, MI 48659
Phone (517) 654-2491

621 Court St
Ste 102
West Branch, MI 48661
Phone (989) 343-9466

8970 Prescott Rd
Whittemore, MI 48770

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jessica.spencer@direct.sterlinghealth.nextgenshare.com

Organizations & group practices 7

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1355961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1083950976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 W MAIN ST",
            "city": "HALE",
            "state": "MI",
            "postal_code": "487399246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 W MAIN ST",
            "city": "HALE",
            "state": "MI",
            "postal_code": "487399246",
            "telephone_number": "989-892-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MSN FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-20",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704227052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083950976",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "SPENCER",
            "middle_name": "LYNN",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hale, MI

Sources for this page

Verify at the official NPI Registry.