Individual provider Active NPI

Heather Wilson

  • Family Nurse Practitioner
  • Montgomery, AL
National Provider Identifier
1174977797
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-118043 Issued in AL
Practice address
2064 East South Blvd
Suite 204
Montgomery, AL 36116-2460
Phone
(334) 281-6990
Fax
(334) 281-9725
NPI assigned
Apr 20, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-118043 AL Primary

Addresses

Primary practice location

2064 East South Blvd
Suite 204
Montgomery, AL 36116-2460

Mailing address

2064 East South Blvd. Ste 204
Montgomery, AL 36116-2460
Phone (334) 281-6990

Other practice location 1

1201 11th Ave S
Birmingham, AL 35205-3423
Phone (205) 930-8339

Other practice location 2

1201 11th Ave S
Birmingham, AL 35205-3423
Phone (205) 930-8339

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address heatherwilson@direct.uabmedicine.org Direct University of Alabama Hospital
Direct Messaging Address heatherwilson@direct.uabmedicine.org Direct University of Alabama Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20160707000939 AL Practitioner - Nurse Practitioner 3375835630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

592 Fieldstown Rd
Suite 114And116
Gardendale, AL 35071-3414
Phone (205) 608-3606

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Aug 1, 2018 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

1201 11th Ave S
Birmingham, AL 35205
Phone (205) 930-7100

2065 E South Blvd
Ste 204
Montgomery, AL 36116
Phone (334) 281-6990

Interoperability endpoints

  • Direct secure messaging: heatherwilson@direct.uabmedicine.org

Organizations & group practices 2

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": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1174977797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2064 EAST SOUTH BLVD. STE 204",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162460",
            "telephone_number": "334-281-6990",
            "fax_number": "334-281-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2064 EAST SOUTH BLVD",
            "address_2": "SUITE 204",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162460",
            "telephone_number": "334-281-6990",
            "fax_number": "334-281-9725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 11th Ave S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352053423",
            "country_code": "US",
            "telephone_number": "205-930-8339",
            "fax_number": "205-930-8934",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 11th Ave S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352053423",
            "country_code": "US",
            "telephone_number": "205-930-8339",
            "fax_number": "205-930-8934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "HEATHER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-20",
        "last_updated": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-118043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "heatherwilson@direct.uabmedicine.org",
            "affiliation": "Y",
            "affiliationName": "University of Alabama Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1201 11th Ave S",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352053423",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "heatherwilson@direct.uabmedicine.org",
            "affiliation": "Y",
            "affiliationName": "University of Alabama Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1201 11th Ave S",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352053423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.