Individual provider Active NPI

Sarah Wilson, APRN

  • Family Nurse Practitioner
  • Mayfield, KY
National Provider Identifier
1144645441
Registry record updated Aug 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3008545 Issued in KY
Practice address
1029 Medical Center Cir
Suite 306
Mayfield, KY 42066-1189
Phone
(270) 251-4575
Fax
(270) 251-4577
NPI assigned
Feb 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3008545 KY
Family Nurse Practitioner 363LF0000X 3008545 KY Primary

Addresses

Primary practice location

1029 Medical Center Cir
Suite 306
Mayfield, KY 42066-1189

Mailing address

1029 Medical Center Cir
Mayfield, KY 42066-1189
Phone (270) 251-4575

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
I20140728002220 KY Practitioner - Nurse Practitioner 0941426928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinelake Physician Practice LLCGroup PAC ID 6800797507, 45 clinicians

Practice addresses (Care Compare)

1029 Medical Ctr Cir
Mayfield, KY 42066-1189

Hospital & facility affiliations

  • Jackson Purchase Medical Center Hospital, Mayfield, KY, CCN 180116
  • Murray-Calloway County Hospital Hospital, Murray, KY, CCN 180027
  • Marshall County Hospital Hospital, Benton, KY, CCN 181327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pinelake Physician Practice, LLC CurrentSince Jan 1, 2016 Accepting new patients
Pinelake Physician Practice, LLC Nurse Practitioner CurrentSince Jan 1, 2016 Accepting new patients
Pinelake Physician Practice, LLC Current Accepting new patients

Locations

1029 Medical Center Cir
Mayfield, KY 42066
Phone (270) 251-4100

1029 Medical Center Cir
Ste 401
Mayfield, KY 42066
Phone (270) 251-4590

1099 Medical Center Cir
Mayfield, KY 42066
Phone (270) 251-4100

1029 Medical Center Cir
Ste 306
Mayfield, KY 42066
Phone (270) 251-4575

Interoperability endpoints

  • Direct secure messaging: sarah.wilson.1@19475.direct.athenahealth.com

Organizations & group practices 3

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 3

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": "1393113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440288000000",
    "number": "1144645441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 MEDICAL CENTER CIR",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420661189",
            "telephone_number": "270-251-4575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 MEDICAL CENTER CIR",
            "address_2": "SUITE 306",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420661189",
            "telephone_number": "270-251-4575",
            "fax_number": "270-251-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SARAH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-23",
        "last_updated": "2015-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3008545",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3008545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield, KY

Sources for this page

Verify at the official NPI Registry.