Jamie Wilson IV, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

APRN11020316 Issued in FL

Practice address

1839 Central Avenue
St Petersburg, FL 33713-8900

Phone

(727) 322-1054

Fax

(727) 821-7213

NPI assigned

Jun 20, 2022

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 2

Other names 1

• Jamie Wilson IV Other name

Medicare fee-for-service enrollment

Enrolled in FL

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

Merit-based Incentive Payment System (MIPS)

Final score

70.73 of 100Reported as group

Quality

8.6

Promoting interoperability

90

Improvement activities

40

Cost

68.84

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EIJHAA

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.

• Professional Health Care of Pinellas LLC

  • Internal Medicine Physician
  • St Petersburg, FL
  • NPI 1881647253
  Medicare reassignment NPD
• Comprehensive Hospital Physicians of Florida Inc

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1245960681

  FL

  Medicare reassignment NPD
• Professional Health Care of Pinellas Inc.

  • Chiropractor
  • St Petersburg, FL
  • NPI 1568970903
  NPD

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1104557206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVENUE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-322-1054",
            "fax_number": "727-821-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVENUE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-322-1054",
            "fax_number": "727-821-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JAMIE",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-20",
        "last_updated": "2024-05-24",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11020316",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11020316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119817600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "JXSUE",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "WILSON",
            "suffix": "IV",
            "credential": "APRN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Carol Wilson, MD
• Carole Louise Wilson, PHARM D
• Christopher H Wilson, D.O.
• Darius Wilson Sr., CBHT
• Elizabeth Wilson, DOM, RD
• Jamie Wilson III, PTA
• Latoya Janelle Wilson, APRN, FNP-C
• Lindsay Edward Wilson, PHD
• Maureen P Wilson
• Nicole Christine Wilson

• Adult Health Nurse Practitioner in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.