Janice Lynn Wilson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A005643 Issued in AR

Practice address

2012 S Promenade Blvd
Rogers, AR 72758

Phone

(479) 616-1485

Fax

(479) 239-0536

NPI assigned

May 16, 2018

Sex

Female

Sole proprietor

Yes

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 AR

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Northwest Arkansas Ambulatory Services, LLCGroup PAC ID 3779827993, 50 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Mercy Northwest Arkansas Ambulatory Services LLC

  • Urgent Care Clinic/Center
  • Springdale, AR
  • NPI 1366922320
  Medicare reassignment Care Compare group NPD
• Siloam Springs Clinic Company LLC

  • Internal Medicine Physician
  • Siloam Springs, AR
  • NPI 1013155431

  Family

  Medicare reassignment NPD
• Mercy Health Northwest Arkansas Communities

  • Multi-Specialty Clinic/Center
  • Rogers, AR
  • NPI 1265490916
  NPD (past)

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

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1235629130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 S PROMENADE BLVD",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727589073",
            "telephone_number": "479-616-1485",
            "fax_number": "479-239-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 S PROMENADE BLVD",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "72758",
            "telephone_number": "479-616-1485",
            "fax_number": "479-239-0536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3721 E US 412 HWY",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Siloam Springs",
            "state": "AR",
            "postal_code": "72761",
            "country_code": "US",
            "telephone_number": "479-215-3080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3721 E US 412 HWY",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Siloam Springs",
            "state": "AR",
            "postal_code": "72761",
            "country_code": "US",
            "telephone_number": "479-215-3080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JANICE",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-16",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Wilson
• Cynthia Renee Wilson, MD
• David Brian Wilson II
• Elizabeth A Wilson, APRN-CNP
• Eric Wilson
• Jason Scott Wilson
• Penny Laine Wilson
• Victoria Ann Wilson, MS CCC-SLP
• Jackson Wimberly
• Jacob A Wingfield, PHARMD

• Family Nurse Practitioner in Rogers, AR
• Providers in Rogers, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; 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.