Loretta Sue Wilson, N.P

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

3005770 Issued in KY

Practice address

39 Cumberland Gap PLZ
Gray, KY 40734-4536

Phone

(606) 526-9005

Fax

(606) 526-8606

NPI assigned

Aug 7, 2008

Last updated

Dec 10, 2018By 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 2

Addresses

Other identifiers 1

Other names 1

• Loretta Sue Hensley Former name

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grace Community Health Center, Inc.Group PAC ID 3870654064, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Corbin Hospital, Corbin, KY, CCN 180080
• Knox County Hospital Hospital, Barbourville, KY, CCN 181328

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lwilson704593@direct.ochin.org

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.

• Grace Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Corbin, KY
  • NPI 1568625648
  Medicare reassignment Care Compare group
• Grace Community Health Center Inc

  dba Hyden Clinic

  • Federally Qualified Health Center (FQHC)
  • Hyden, KY
  • NPI 1598207557
  NPD
• Apogee Medical Group Kentucky PSC

  • General Practice Physician
  • Corbin, KY
  • NPI 1356503114

  Nurse Practitioner

  NPD (past)
• London Women's Care, LLC

  • Obstetrics & Gynecology Physician
  • London, KY
  • NPI 1063454650
  NPD (past)

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

• Arh Mary Breckinridge Health Services, Inc.

  dba ARH Cumberland Valley Medical and Surgical Associates

  • Rural Health Clinic/Center
  • Middlesboro, KY
  • NPI 1962908277

  Hospital

  Care Compare affiliation
• Arh Mary Breckinridge Health Services, Inc.

  dba Barbourville ARH Hospital

  • Critical Access Hospital
  • Barbourville, KY
  • NPI 1992176655
  Care Compare affiliation
• Baptist Healthcare System, Inc

  dba Baptist Health Corbin

  • General Acute Care Hospital
  • Corbin, KY
  • NPI 1902865389
  Care Compare affiliation

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1407002603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 CUMBERLAND FALLS HWY",
            "address_2": "SUITE B201",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012735",
            "telephone_number": "606-526-9005",
            "fax_number": "606-526-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 CUMBERLAND GAP PLZ",
            "city": "GRAY",
            "state": "KY",
            "postal_code": "407344536",
            "telephone_number": "606-526-9005",
            "fax_number": "606-526-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LORETTA",
        "middle_name": "SUE",
        "credential": "N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-07",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3005770",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "1083291",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100089740",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORETTA",
            "last_name": "HENSLEY",
            "middle_name": "SUE",
            "credential": "N.P",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tammy S. Saylor, APRN
• Jessica Ashley Scearse
• Edna Eugenia Stewart, ARNP
• Superior Home Sleep Testing
• Vernon Eugene Taylor Jr., APRN
• Roberta L. York, APRN

• Nurse Practitioner in Gray, KY
• Providers in Gray, KY by specialty
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.