NPIMap

Individual provider Active NPI

Madeleine R. Wilson, MD

  • Family Medicine Physician
  • Lincoln, NE
National Provider Identifier
1154981033
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
TEP8534 Issued in NE
Practice address
4600 Valley Rd Ste 200
Lincoln, NE 68510-4882
Phone
(402) 483-4571
Fax
(402) 483-5633
NPI assigned
Jun 13, 2019
Last updated
Apr 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TEP8534 NE Primary

Addresses

Primary practice location

4600 Valley Rd Ste 200
Lincoln, NE 68510-4882

Mailing address

4600 Valley Rd Ste 200
Lincoln, NE 68510-4882
Phone (402) 483-4571

Other identifiers 1

IdentifierTypeStateIssuer
470553011-00MedicaidNE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address madeleine.wilson.1@9271.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20210107001546 NE Practitioner - Family Practice 9638409592 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherry County HospitalGroup PAC ID 5698686012, shared by 6 NPIs, 24 clinicians

Practice addresses (Care Compare)

510 N Green St
Valentine, NE 69201-1932
Phone (402) 376-2525

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TEP8534NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cherry County Hospital Family Medicine CurrentSince Sep 7, 2022 Accepting new patients
Cherry County Hospital Current Accepting new patients
Cherry County Hospital CurrentSince Sep 7, 2022 Accepting new patients
Osmond General Hospital Inc Family Medicine CurrentSince Dec 26, 2020 Accepting new patients
Osmond General Hospital Inc Family Medicine Current Accepting new patients
Osmond General Hospital Inc CurrentSince Dec 26, 2020 Accepting new patients

Locations

510 N Green St
Valentine, NE 69201
Phone (402) 376-3770

512 N Green St
Valentine, NE 69201
Phone (402) 376-3770

Organizations & group practices 6

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 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": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1154981033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 VALLEY RD STE 200",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104882",
            "telephone_number": "402-483-4571",
            "fax_number": "402-483-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 VALLEY RD STE 200",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104882",
            "telephone_number": "402-483-4571",
            "fax_number": "402-483-5633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MADELEINE",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "TEP8534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470553011-00",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "madeleine.wilson.1@9271.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "4600 Valley Rd Ste 200",
            "city": "Lincoln",
            "state": "NE",
            "country_code": "US",
            "postal_code": "685104882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.