Individual provider Active NPI

Valerie Wilson, APRN

  • Nurse Practitioner
  • Bowling Green, KY
National Provider Identifier
1114567047
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3013864 Issued in KY
Practice address
825 2ND Ave Ste B6
Bowling Green, KY 42101-1790
Phone
(270) 670-6629
Fax
(270) 393-9830
NPI assigned
Jan 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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 3013864 KY Primary

Addresses

Primary practice location

825 2ND Ave Ste B6
Bowling Green, KY 42101-1790

Mailing address

825 2ND Ave Ste B6
Bowling Green, KY 42101-1790
Phone (270) 670-6629

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20200420001496 KY Practitioner - Nurse Practitioner 4981034725 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3013864KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Health Corporation, Inc Nurse Practitioner Current Accepting new patients
Commonwealth Health Corporation, Inc. Nurse Practitioner CurrentSince Sep 27, 2024 Accepting new patients
Commonwealth Health Corporation, Inc. CurrentSince Sep 27, 2024 Accepting new patients
Western Kentucky Gastroenterology Associates, LLC Past Accepting new patients
Western Kentucky Gastroenterology, LLC Past Accepting new patients

Locations

250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000

825 2nd Ave
Ste B1
Bowling Green, KY 42101
Phone (270) 843-8600

421 US 31W Byp
Bowling Green, KY 42101
Phone (270) 782-7768

825 2nd Ave
Ste B6
Bowling Green, KY 42101
Phone (270) 780-2690

350 Park St
Ste 203
Bowling Green, KY 42101
Phone (270) 781-0075

Interoperability endpoints

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

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1114567047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 2ND AVE STE B6",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011790",
            "telephone_number": "270-670-6629",
            "fax_number": "270-393-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 2ND AVE STE B6",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011790",
            "telephone_number": "270-670-6629",
            "fax_number": "270-393-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "VALERIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-08",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3013864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.