Individual provider Active NPI

Jennifer Kay Wilcox, NP

  • Family Nurse Practitioner
  • Jamestown, NY
National Provider Identifier
1134438567
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F343751-1 Issued in NY
Practice address
107 Institute St
Jamestown, NY 14701-6628
Phone
(716) 484-4334
Fax
(833) 974-2029
NPI assigned
Oct 4, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 591639 NY
Family Nurse Practitioner 363LF0000X F343751-1 NY Primary

Addresses

Primary practice location

107 Institute St
Jamestown, NY 14701-6628

Mailing address

152 Foote Ave
Jamestown, NY 14701
Phone (716) 664-5290

Other practice location 1

21 E 3rd St Ste 103
Jamestown, NY 14701-5113
Phone (716) 969-4156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190214000526 NY Practitioner - Nurse Practitioner 1355689571 Reassigns benefits to 2 organizations
I20210716000865 PA Practitioner - Nurse Practitioner 1355689571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Chautauqua Center IncGroup PAC ID 7214178326, 35 clinicians
Umamaheswara Rao Vejendla Physician PCGroup PAC ID 9133180888, 4 clinicians

Practice addresses (Care Compare)

107 Institute St
Jamestown, NY 14701-6628
Phone (716) 363-6050

152 Foote Ave
Jamestown, NY 14701-6940
Phone 7166645290208

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
591639NYMDRegistered Nurse
F343751-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Chautauqua Center, Inc CurrentSince Dec 19, 2018 Accepting new patients
Ahn Hospitalist Group, LTD CurrentSince May 11, 2022 Accepting new patients
Umamaheswara Rao Vejendla Physician PC CurrentSince Aug 19, 2024 Accepting new patients
County of Chautauqua - a Mun Corp Past Accepting new patients
Chautauqua PT OT & SLP Professionals PLLC Past Accepting new patients

Locations

1134 Central Ave
Dunkirk, NY 14048
Phone (716) 366-6036

107 Institute St
Jamestown, NY 14701
Phone (716) 484-4334

110 E 4th St
Jamestown, NY 14701
Phone (716) 484-4334

152 Foote Ave
Jamestown, NY 14701
Phone (716) 664-5290

835 Hospital Rd
Indiana, PA 15701
Phone (724) 357-7000

2 W Crescent Park
Warren, PA 16365
Phone (814) 452-5337

Interoperability endpoints

  • Direct secure messaging: jwilcox@vejendla.medentdirect.com
  • Direct secure messaging: jennifer.wilcox.1@22211.direct.athenahealth.com

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1134438567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 FOOTE AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "14701",
            "telephone_number": "716-664-5290",
            "fax_number": "716-664-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 INSTITUTE ST",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016628",
            "telephone_number": "716-484-4334",
            "fax_number": "833-974-2029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 E 3rd St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Jamestown",
            "state": "NY",
            "postal_code": "147015113",
            "country_code": "US",
            "telephone_number": "716-969-4156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "JENNIFER",
        "middle_name": "KAY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-04",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "591639",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F343751-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

Verify at the official NPI Registry.