Jacquetta Nicole Wilson, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

3013748 Issued in KY

Practice address

3950 Kresge Way Ste 308
Louisville, KY 40207-4637

Phone

(502) 895-8911

Fax

(502) 895-8977

NPI assigned

Oct 3, 2019

Last updated

Dec 1, 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

Electronic endpoints 1

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

Group practices

Louisville Hospitalist Associates PLLCGroup PAC ID 1456451715, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Louisville Hospital, Louisville, KY, CCN 180130

Merit-based Incentive Payment System (MIPS)

Final score

94.29 of 100Reported as apm

Quality

87.32

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwilson12798@bhkydirect.com

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.

• Louisville Hospitalist Associates PLLC

  • Hospitalist Physician
  • Louisville, KY
  • NPI 1962531731

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Baptist Health Medical Group Inc

  dba Dawson Springs Rural Health Clinic

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216
  Medicare reassignment NPD
• Baptist Health Medical Group, Inc.

  • Family Medicine Physician
  • Jeffersonville, IN
  • NPI 1811648827

  Nurse Practitioner

  NPD

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

• Baptist Healthcare System Inc.

  dba Baptist Health Louisville

  • General Acute Care Hospital
  • Louisville, KY
  • NPI 1265539498
  Care Compare affiliation

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1265073985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9203",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049159203",
            "telephone_number": "502-895-9627",
            "fax_number": "502-895-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 KRESGE WAY STE 308",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074637",
            "telephone_number": "502-895-8911",
            "fax_number": "502-895-8977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 Eastpoint Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402234154",
            "country_code": "US",
            "telephone_number": "502-210-4800",
            "fax_number": "502-210-4810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JACQUETTA",
        "middle_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3013748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwilson12798@bhkydirect.com",
            "affiliation": "N",
            "address_1": "2400 Eastpoint Pkwy Ste 100",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402234154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emily M Wilson, APRN
• Erika Brandi Wilson, LCSW
• Ethan Wilson
• Heather Lynn Wilson, MD
• Jacqueline Latia Wilson, FNP-C
• James Dylan Wilson, APRN
• James Edwin Wilson, L.P.C.C.
• Jamesha Wilson
• Jaren Wilson
• John Marshall Wilson, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.