Individual provider Active NPI

Renee Anne Wilson, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Greenfield, IN
National Provider Identifier
1255977039
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71009583A Issued in IN
Practice address
1107 N State St
Greenfield, IN 46140-1207
Phone
(173) 967-2180
NPI assigned
Nov 27, 2019
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71009583A IN Primary
Registered Nurse 163W00000X 28209352A IN

Addresses

Primary practice location

1107 N State St
Greenfield, IN 46140-1207

Mailing address

1503 N Mitthoeffer Rd
Indianapolis, IN 46229-2425
Phone (317) 934-0768

Other practice location 1

9783 E 116th St
Fishers, IN 46037-2822
Phone (317) 751-4832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20201002000401 IN Practitioner - Nurse Practitioner 4082033576 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jane Pauley Community Health Center IncGroup PAC ID 7618152729, 77 clinicians

Practice addresses (Care Compare)

1503 N Mitthoefer Rd
Indianapolis, IN 46229-2425

153 N Mitthoefer Rd
Indianapolis, IN 46229-2425

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28209352AINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Apr 1, 2025 Accepting new patients
Sondermind Provider Network LLC Psychiatric/Mental Health CurrentSince Aug 9, 2025 Accepting new patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients
Major Hospital Past Accepting new patients
Jpchc Pharmacy LLC PastSince Dec 1, 2019 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

333 N Alabama St
Indianapolis, IN 46204
Phone (317) 395-3391

333 N Alabama St
Ste 350
Indianapolis, IN 46204
Phone (317) 983-0002

9465 Counselors Row
Ste 200
Indianapolis, IN 46240
Phone (463) 220-4646

Interoperability endpoints

  • Direct secure messaging: rwilson295962@direct.ochin.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1255977039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 N MITTHOEFFER RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292425",
            "telephone_number": "317-934-0768",
            "fax_number": "317-469-1658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 N STATE ST",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461401207",
            "telephone_number": "173-967-2180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9783 E 116th St",
            "address_purpose": "LOCATION",
            "city": "Fishers",
            "state": "IN",
            "postal_code": "460372822",
            "country_code": "US",
            "telephone_number": "317-751-4832",
            "fax_number": "317-751-4832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "RENEE",
        "middle_name": "ANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-27",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71009583A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28209352A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, IN

Sources for this page

Verify at the official NPI Registry.