Individual provider Active NPI

Stephanie Wilson, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1386060929
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18432 Issued in TN
Practice address
2358 Lifestyle Way Ste 100
Chattanooga, TN 37421-4907
Phone
(423) 602-2750
Fax
(423) 602-2762
NPI assigned
Mar 6, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A810574 MS
Family Nurse Practitioner 363LF0000X APRN11027260 FL
Family Nurse Practitioner 363LF0000X 18432 TN Primary

Addresses

Primary practice location

2358 Lifestyle Way Ste 100
Chattanooga, TN 37421-4907

Mailing address

2358 Lifestyle Way Ste 100
Chattanooga, TN 37421-4907
Phone (423) 602-2750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140609000436 TN Practitioner - Nurse Practitioner 5395969661 Reassigns benefits to 1 organization
I20230828002722 FL Practitioner - Nurse Practitioner 5395969661

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vascular Institute of Chattanooga, PLLCGroup PAC ID 1658671052, 19 clinicians

Practice addresses (Care Compare)

2358 Lifestyle Way
Suite 100
Chattanooga, TN 37421-4907
Phone (423) 602-2750

Hospital & facility affiliations

  • Parkridge Medical Center Hospital, Chattanooga, TN, CCN 440156
  • Memorial Healthcare System, Inc Hospital, Chattanooga, TN, CCN 440091
  • Erlanger Medical Center Hospital, Chattanooga, TN, CCN 440104

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
White-Wilson Medical Center PA CurrentSince Sep 7, 2023 Accepting new patients
Vascular Institute of Chattanooga, PLLC CurrentSince Feb 26, 2025 Accepting new patients

Locations

1106 Hospital Rd
Ft Walton Bch, FL 32547
Phone (850) 863-8169

1005 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 863-8100

4622 Battlefield Pkwy
Ringgold, GA 30736

2358 Lifestyle Way
Ste 100
Chattanooga, TN 37421
Phone 4236022750104

2158 Northgate Park Ln
Ste 102
Chattanooga, TN 37415
Phone (423) 664-3366

Interoperability endpoints

  • Direct secure messaging: wilson.stephanie@direct.vic.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1386060929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2358 LIFESTYLE WAY STE 100",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214907",
            "telephone_number": "423-602-2750",
            "fax_number": "423-602-2762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2358 LIFESTYLE WAY STE 100",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214907",
            "telephone_number": "423-602-2750",
            "fax_number": "423-602-2762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "STEPHANIE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-06",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "A810574",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11027260",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.