Susan E Wilson, CPNP

Primary specialty

Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X

License

APN12098 Issued in TN

Practice address

616 Smithview Dr
Maryville, TN 37803-6100

Phone

(865) 379-2277

Fax

(865) 738-0087

NPI assigned

Jul 11, 2006

Last updated

Mar 7, 2023By 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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

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.

• Cedar Creek Pediatric & Adolescent Medicine, PC

  • Pediatrics Physician
  • Maryville, TN
  • NPI 1003039223
  NPD (past)
• Otolaryngology Center of East Tennessee PC

  • Otolaryngology Physician
  • Maryville, TN
  • NPI 1639197593
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1336174093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 SMITHVIEW DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378036100",
            "telephone_number": "865-379-2277",
            "fax_number": "865-738-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 SMITHVIEW DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378036100",
            "telephone_number": "865-379-2277",
            "fax_number": "865-738-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "TN",
            "license": "APN12098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE ID #",
            "identifier": "APN0000012098",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD CERTIFICATION #",
            "identifier": "20060525",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN STATE LICENSE",
            "identifier": "RN0000096921",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mollie Caitlyn Willocks, CCMA
• Ludmila Marie Wilner
• Aleisha Diane Wilson, COTA/L
• Jennifer Ann Wilson
• Rachel Click Wilson, DO
• William Caleb Wilson, MD
• Jennifer Allison Winbigler, M.D.
• Mariah Michelle Winningham, FNP-C
• Deborah Winoker, LCSW
• Sarah Nicole Winstead, CCC-SLP

• Critical Care Neonatal Nurse Practitioner in Maryville, TN
• Providers in Maryville, TN by specialty
• Critical Care Neonatal Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.