Individual provider Active NPI

Jer'Donna Downesha Wilson, CRNP

  • Family Nurse Practitioner
  • Prattville, AL
National Provider Identifier
1336515907
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-132303 Issued in AL
Practice address
1965 Cobbs Ford Rd
Prattville, AL 36066-7290
Phone
(334) 323-1330
Fax
(334) 361-8750
NPI assigned
Aug 18, 2015
Last updated
Apr 4, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-132303 AL Primary

Addresses

Primary practice location

1965 Cobbs Ford Rd
Prattville, AL 36066-7290

Mailing address

921 Cruz CT
Montgomery, AL 36110-3236
Phone (334) 202-3505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20151014000857 AL Practitioner - Nurse Practitioner 3476862491 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Family Care, LLCGroup PAC ID 9739087818, 180 clinicians

Practice addresses (Care Compare)

101 Paul Stabler Dr
Greenville, AL 36037-3133
Phone (334) 382-0734

1965 Cobbs Ford Rd
Prattville, AL 36066-7290
Phone (334) 361-7054

2570 Berryhill Rd
Montgomery, AL 36117-3564
Phone (334) 323-1330

2815 Eastern Blvd
Montgomery, AL 36116-1021
Phone (334) 323-2050

34 Taylor Rd N
Montgomery, AL 36117-6753
Phone (334) 323-1510

4305 Atlanta Hwy
Montgomery, AL 36109-3101
Phone (334) 323-2260

4452 US Hwy 231
Wetumpka, AL 36092-3328
Phone (334) 472-3150

8151 Whitesburg Dr SE
Huntsville, AL 35802-4557
Phone (256) 882-9711

Merit-based Incentive Payment System (MIPS)

Final score
70.43 of 100Reported as group
Quality
65.59
Improvement activities
40
Cost
64.54

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
American Family Care, LLC CurrentSince Sep 15, 2015 Accepting new patients
American Family Care, LLC CurrentSince Sep 15, 2015 Accepting new patients
American Family Care, LLC Current Accepting new patients

Locations

3700 Cahaba Beach Rd
Hoover, AL 35242
Phone (205) 403-8902

8151 Whitesburg Dr SE
Huntsville, AL 35802
Phone (256) 882-9711

4305 Atlanta Hwy
Montgomery, AL 36109
Phone (334) 271-7051

1965 Cobbs Ford Rd
Prattville, AL 36066
Phone (334) 323-1330

Organizations & group practices 4

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": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1336515907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 CRUZ CT",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361103236",
            "telephone_number": "334-202-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 COBBS FORD RD",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360667290",
            "telephone_number": "334-323-1330",
            "fax_number": "334-361-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JER'DONNA",
        "middle_name": "DOWNESHA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-132303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prattville, AL

Sources for this page

Verify at the official NPI Registry.