Individual provider Active NPI

Wendy Wilcox, NP

  • Family Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1366927683
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP139024 Issued in TX
Practice address
5028 122ND St
Lubbock, TX 79424-8398
Phone
(806) 749-7975
Fax
(806) 749-7937
NPI assigned
Oct 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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 AP139024 TX Primary

Addresses

Primary practice location

5028 122ND St
Lubbock, TX 79424-8398

Mailing address

12206 Orlando Ave
Lubbock, TX 79423-5779
Phone (806) 773-1629

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20181023000484 TX Practitioner - Nurse Practitioner 9133472012 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Owen Health Group, PLLC CurrentSince Oct 2, 2018 Accepting new patients

Locations

5028 122nd St
Lubbock, TX 79424
Phone (806) 392-0403

Interoperability endpoints

  • Direct secure messaging: owenhealthgrouppllc.wendywilcox@136464.advancedmd-direct.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1366927683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12206 ORLANDO AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794235779",
            "telephone_number": "806-773-1629",
            "fax_number": "806-749-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5028 122ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794248398",
            "telephone_number": "806-749-7975",
            "fax_number": "806-749-7937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "WENDY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.