NPIMap

Individual provider Active NPI

Jennifer Wilson, M.D.

  • Hospitalist Physician
  • Meadville, PA
National Provider Identifier
1205958022
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD063892L Issued in PA
Practice address
751 Liberty St
Meadville, PA 16335-2559
Phone
(814) 333-7016
Fax
(814) 373-3543
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD063892L PA
Hospitalist Physician 208M00000X MD063892L PA Primary

Addresses

Primary practice location

751 Liberty St
Meadville, PA 16335-2559

Mailing address

1034 Grove St
Meadville, PA 16335-2945
Phone (814) 333-7016

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwilson192279@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20120223000378 PA Practitioner - Family Practice 3476711367 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Rochester School of Medicine and Dentistry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

532 W Pittsburgh St
Excela Health Hospitalists
Greensburg, PA 15601-2282
Phone (724) 850-6957

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD063892LPAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Erie Medical Group PC Family Medicine CurrentSince May 6, 2012 Accepting new patients
Fayette Physician Network Inc Family Medicine Current Accepting new patients
St Vincent Medical Education and Research Institute Inc Family Medicine CurrentSince Jul 1, 2016 Accepting new patients
Upmc Altoona CurrentSince Mar 1, 2024 Accepting new patients
Upmc Altoona CurrentSince Mar 1, 2024 Accepting new patients
Excela Health Physician Practices, Inc Current Accepting new patients
Apogee Medical Group of Pennsylvania PC CurrentSince Jul 2, 2016 Accepting new patients
Excela Health Physician Practices, Inc. Family Medicine CurrentSince Dec 25, 2018 Accepting new patients
Fayette Physician Network Inc Family Medicine CurrentSince Mar 3, 2018 Accepting new patients
Apogee Medical Group of Pennsylvania PC CurrentSince Jul 2, 2016 Accepting new patients
Excela Health Physician Practices, Inc. CurrentSince Dec 25, 2018 Accepting new patients
Fayette Physician Network Inc Family Medicine CurrentSince Mar 3, 2018 Accepting new patients
Meadville Medical Center Past Accepting new patients

Locations

155 E State St
Albion, PA 16401
Phone (814) 756-4917

620 Howard Ave
Altoona, PA 16601
Phone (814) 889-2011

232 W 25th St
Erie, PA 16544
Phone (814) 452-5337

145 W 23rd St
Ste 202
Erie, PA 16502
Phone (814) 580-5600

532 W Pittsburgh St
Greensburg, PA 15601
Phone (724) 832-4000

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

1 Mellon Way
Latrobe, PA 15650
Phone (724) 537-1207

500 W Berkeley St
Uniontown, PA 15401
Phone (724) 430-5000

201 Mary Higginson Ln
Uniontown, PA 15401
Phone (724) 430-5940

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 22

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 22

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1205958022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 GROVE ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352945",
            "telephone_number": "814-333-7016",
            "fax_number": "814-373-3543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 LIBERTY ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352559",
            "telephone_number": "814-333-7016",
            "fax_number": "814-373-3543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD063892L",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD063892L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwilson192279@direct.ahn.org",
            "affiliation": "N",
            "address_1": "232 W 25th St",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165440002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Meadville, PA

Sources for this page

Verify at the official NPI Registry.