Individual provider Active NPI

Gracen Kelly Wilson, APRN

  • Family Nurse Practitioner
  • Rome, GA
National Provider Identifier
1184503807
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN317878 Issued in GA
Practice address
15 Riverbend Dr SW
Rome, GA 30161-6005
Phone
(706) 291-0884
Fax
(706) 291-1241
NPI assigned
Aug 27, 2025
Last updated
Oct 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2026

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 RN317878 GA Primary

Addresses

Primary practice location

15 Riverbend Dr SW
Rome, GA 30161-6005

Mailing address

14 Horseshoe Bend Rd SW
Rome, GA 30165-8548
Phone (706) 728-5781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20251222002229 GA Practitioner - Nurse Practitioner 3870088339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Floyd Healthcare Management IncGroup PAC ID 5193633386, 133 clinicians

Practice addresses (Care Compare)

15 Riverbend Dr SW
Rome, GA 30161-6005
Phone (706) 291-0084

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN317878GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd Healthcare Management Inc CurrentSince Dec 1, 2025 Accepting new patients
Floyd Healthcare Management Inc Family CurrentSince Dec 1, 2025 Accepting new patients

Locations

1025 N Main St
Cedartown, GA 30125
Phone (770) 748-5212

15 Riverbend Dr SW
Rome, GA 30161
Phone (706) 291-0084

15 Riverbend Dr SW
Ste 100
Rome, GA 30161
Phone (706) 291-0884

Interoperability endpoints

  • Direct secure messaging: gwilson2957866@carolinashealthcaresystem.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1756252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1184503807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 HORSESHOE BEND RD SW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301658548",
            "telephone_number": "706-728-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 RIVERBEND DR SW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301616005",
            "telephone_number": "706-291-0884",
            "fax_number": "706-291-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "GRACEN",
        "middle_name": "KELLY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-27",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN317878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.