Jacquelyn Ann Wilson, CNP
Individual provider Active NPI Family Nurse Practitioner · Audubon, IA
NPI 1326414947 · NPPES record last updated Nov 20, 2022
Key facts
- NPI
- 1326414947
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- A145802 (IA)
- Practice address
- 515 Pacific Ave
Audubon, IA 50025-1056 - Phone
- (712) 563-2611
- Fax
- (712) 563-5248
- NPI assigned
- Aug 18, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Audubon County Memorial Hospital
Practice addresses (Care Compare)
515 Pacific Ave
Audubon, IA 50025-1056
Phone (712) 563-2611
Hospital & facility affiliations
- Audubon County Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.09 of 100
- Quality
- 92.17
- Promoting interoperability
- 88
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190726000529 | IA | Practitioner - Nurse Practitioner | 1759690738 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cass County Memorial Hospital | Current |
Accepting new patients | |
| Cass County Memorial Hospital | Current |
Accepting new patients | |
| Audubon County Memorial Hospital | Current | Accepting new patients | |
| Audubon County Memorial Hospital | Current |
Accepting new patients |
Locations
1501 E 10th St
Atlantic, IA 50022
Phone (712) 243-2850
1501 E 10th St
Ste 120
Atlantic, IA 50022
Phone (712) 243-2850
515 Pacific Ave
Audubon, IA 50025
Phone (712) 563-2611
Interoperability endpoints
- jwilson222538@uihcdirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A145802 | IA | Yes |
Addresses
Primary practice location
515 Pacific Ave
Audubon, IA 50025-1056
Mailing address
402 W Morrow Rd
Sand Springs, OK 74063-6549
Phone (918) 770-3134
Other providers in Audubon, IA
- Touching Lives Center, LLC
- Stephanie Vampola-Runyan
- Vivian D Chance Arnp LLC
- Kimberly Ann Vollstedt
- Tyler James Williams
- With Hope LLC
All providers in Audubon, IA · Family Nurse Practitioner in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.