Individual provider Active NPI

Brett Wilson, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Logan, OH
National Provider Identifier
1164839031
Registry record updated Jan 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
16225 Issued in OH
Practice address
541 State Route 664 N
Suite C
Logan, OH 43138-8541
Phone
(740) 385-6594
Fax
(740) 380-0852
NPI assigned
Jul 12, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 16225 OH Primary

Addresses

Primary practice location

541 State Route 664 N
Suite C
Logan, OH 43138-8541

Mailing address

1049 Western Ave
P.O. Box 188
Chillicothe, OH 45601-1104
Phone (740) 773-4366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20141029001738 OH Practitioner - Nurse Practitioner 9830310150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hopewell Health Centers, Inc.Group PAC ID 9234049990, 55 clinicians

Practice addresses (Care Compare)

541 State Route 664 N
Suite C
Logan, OH 43138-8541
Phone (740) 385-6594

90 Hospital Dr
Athens, OH 45701-2301
Phone (740) 592-3091

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16225OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hopewell Health Centers, Inc. CurrentSince Aug 1, 2014 Accepting new patients
Hopewell Health Centers Inc Current Accepting new patients
Hopewell Health Centers Inc CurrentSince Aug 1, 2014 Accepting new patients

Locations

90 Hospital Dr
Athens, OH 45701
Phone (740) 592-3091

1049 Western Ave
Chillicothe, OH 45601
Phone (740) 773-1006

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 1

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": "1405123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1164839031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 WESTERN AVE",
            "address_2": "P.O. BOX 188",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456011104",
            "telephone_number": "740-773-4366",
            "fax_number": "740-775-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 STATE ROUTE 664 N",
            "address_2": "SUITE C",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431388541",
            "telephone_number": "740-385-6594",
            "fax_number": "740-380-0852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRETT",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-12",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "16225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, OH

Sources for this page

Verify at the official NPI Registry.