Jacquelyn Ann Wilson, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A145802 Issued in IA

Practice address

515 Pacific Ave
Audubon, IA 50025-1056

Phone

(712) 563-2611

Fax

(712) 563-5248

NPI assigned

Aug 18, 2015

Last updated

Nov 20, 2022By 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 IA

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Audubon County Memorial HospitalGroup PAC ID 7618866096, shared by 5 NPIs, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Audubon County Memorial Hospital Hospital, Audubon, IA, CCN 161330

Merit-based Incentive Payment System (MIPS)

Final score

92.09 of 100Reported as group

Quality

92.17

Promoting interoperability

88

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwilson222538@uihcdirect.org

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.

• Audubon County Memorial Hospital

  • Critical Access Hospital
  • Audubon, IA
  • NPI 1710951686
  Medicare reassignment NPD
• Audubon County Memorial Hospital

  • Emergency Medicine Physician
  • Audubon, IA
  • NPI 1730153420
  Medicare reassignment NPD
• Cass County Memorial Hospital

  • Critical Access Hospital
  • Atlantic, IA
  • NPI 1861597122
  Medicare reassignment NPD
• Cass County Memorial Hospital

  dba Cass Health Pharmacy

  • Community/Retail Pharmacy
  • Atlantic, IA
  • NPI 1023755097
  NPD

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

• Audubon County Memorial Hospital

  • Critical Access Hospital
  • Audubon, IA
  • NPI 1710951686
  Care Compare affiliation

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668902400000",
    "number": "1326414947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W MORROW RD",
            "city": "SAND SPRINGS",
            "state": "OK",
            "postal_code": "740636549",
            "telephone_number": "918-770-3134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 PACIFIC AVE",
            "city": "AUDUBON",
            "state": "IA",
            "postal_code": "500251056",
            "telephone_number": "712-563-2611",
            "fax_number": "712-563-5248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JACQUELYN",
        "middle_name": "ANN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2022-11-20",
        "certification_date": "2022-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A145802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Touching Lives Center, LLC
• Stephanie Vampola-Runyan, D.O.
• Vivian D Chance Arnp LLC (Audubon Medical Clinic)
• Kimberly Ann Vollstedt, PHARMD
• Tyler James Williams, ARNP
• With Hope LLC

• Family Nurse Practitioner in Audubon, IA
• Providers in Audubon, IA by specialty
• Family Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2022; 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.