Jacqueline Latia Wilson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3013705 Issued in KY

Practice address

225 N Clifton Ave
Louisville, KY 40206-2496

Phone

(502) 794-3894

Fax

(502) 794-2873

NPI assigned

Sep 8, 2019

Last updated

Mar 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Strickland, Cox and Associates Primary Care CenterGroup PAC ID 7214228931, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Strickland, Cox & Associates Primary Care Center

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1578917407
  Medicare reassignment Care Compare group NPD
• Havehope Counseling & Consulting, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Louisville, KY
  • NPI 1568023661

  Family

  Medicare reassignment NPD
• Havehope Wellness

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1295622942
  Medicare reassignment NPD

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

{
    "created_epoch": "1567900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1225687791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N CLIFTON AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402062496",
            "telephone_number": "502-794-3894",
            "fax_number": "502-794-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N CLIFTON AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402062496",
            "telephone_number": "502-794-3894",
            "fax_number": "502-794-2873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7012 Watson Ln",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402721143",
            "country_code": "US",
            "telephone_number": "270-219-9039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JACQUELINE",
        "middle_name": "LATIA",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-08",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3013705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dena Eilers Wilson
• Emily M Wilson, APRN
• Erika Brandi Wilson, LCSW
• Ethan Wilson
• Heather Lynn Wilson, MD
• Jacquetta Nicole Wilson, APRN
• James Dylan Wilson, APRN
• James Edwin Wilson, L.P.C.C.
• Jamesha Wilson
• Jaren Wilson

• Family Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; 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.