Krista Lynn Wilson, A.R.N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

A088603 Issued in IA

Practice address

415 Main St
Malvern, IA 51551-8152

Phone

(712) 624-9185

Fax

(712) 624-8827

NPI assigned

Feb 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IA, NE2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shenandoah Medical Center 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Angels Care Home Health of Iowa Home health agency, Council Bluffs, IA, CCN 167292
• Shenandoah Medical Center Hospital, Shenandoah, IA, CCN 161366
• George C Grape Community Hospital Hospital, Hamburg, IA, CCN 161324

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristawilson@shenmed.allscriptsdirect.net

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.

• Shenandoah Medical Center

  • Certified Registered Nurse Anesthetist
  • Shenandoah, IA
  • NPI 1497810972

  IA

  Medicare reassignment Care Compare group NPD
• Shenandoah Medical Center

  • Rural Health Clinic/Center
  • Shenandoah, IA
  • NPI 1427300201
  Care Compare group NPD
• Shenandoah Medical Center

  • Community/Retail Pharmacy
  • Shenandoah, IA
  • NPI 1447937230
  Care Compare group NPD
• Shenandoah Medical Center

  • Critical Access Hospital
  • Shenandoah, IA
  • NPI 1184621096
  Care Compare group NPD (past)
• Shenandoah Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Shenandoah, IA
  • NPI 1346304524
  Care Compare group
• Shenandoah Medical Center

  • Rural Health Clinic/Center
  • Sidney, IA
  • NPI 1497150825
  Care Compare group
• Shenandoah Medical Center

  • Rural Health Clinic/Center
  • Tabor, IA
  • NPI 1508487547
  Care Compare group
• New Century Physicians of Iowa PC

  • Emergency Medicine Physician
  • Council Bluffs, IA
  • NPI 1548269301
  NPD
• Shenandoah Medical Center

  • Emergency Medicine Physician
  • Shenandoah, IA
  • NPI 1497810956
  NPD
• New Century Physicians of Nebraska LLC

  • Emergency Medicine Physician
  • Omaha, NE
  • NPI 1013916600
  NPD
• New Century Physicians of Nebraska LLC

  • Emergency Medicine Physician
  • Papillion, NE
  • NPI 1063411833
  NPD
• Alegent Creighton Health

  • Emergency Medicine Physician
  • Omaha, NE
  • NPI 1629343041

  Nurse Practitioner

  NPD (past)

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

• Community Hospital Inc

  • Critical Access Hospital
  • Hamburg, IA
  • NPI 1932294071

  Hospital

  Care Compare affiliation
• Family Touch Home Health Care, LLC

  • Home Health Agency
  • Council Bluffs, IA
  • NPI 1902805039
  Care Compare affiliation
• Shenandoah Medical Center

  • Critical Access Hospital
  • Shenandoah, IA
  • NPI 1184621096

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1225001464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MAIN ST",
            "city": "MALVERN",
            "state": "IA",
            "postal_code": "515518152",
            "telephone_number": "712-624-9185",
            "fax_number": "712-624-8827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KRISTA",
        "middle_name": "LYNN",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IA",
            "license": "A088603",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A088603",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "110991",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225001464",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731777",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731712",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470687317-16",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaleb Richter, PTA, CPT
• Sakrx, LLC
• Sakrx, LLC
• Sakrx, LLC
• Amberly Wiese, OTR

• All providers in Malvern, IA
• Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.