Douglas Van Wilson, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-107799 Issued in AL

Practice address

47344 US Highway 78
Lincoln, AL 35096-6748

Phone

(205) 763-7848

NPI assigned

Jun 28, 2019

Last updated

Jun 28, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Florence, AL
  • NPI 1639679962
  Medicare reassignment Care Compare group NPD
• Baptist Health Centers, LLC

  dba Baptist Health Medical Group

  • Health Service Clinic/Center
  • Winfield, AL
  • NPI 1265496236
  Medicare reassignment NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498
  Medicare reassignment NPD
• Baptist Health Centers LLC

  dba Baptist Health Medical Group

  • Specialist
  • Talladega, AL
  • NPI 1669436721
  NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Ocoee, FL
  • NPI 1326906843
  NPD
• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865
  NPD (past)

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

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1407417538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 22ND ST S STE 1000",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352052881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47344 US HIGHWAY 78",
            "city": "LINCOLN",
            "state": "AL",
            "postal_code": "350966748",
            "telephone_number": "205-763-7848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DOUGLAS",
        "middle_name": "VAN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-28",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-107799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Walker
• Rebecca Lynn Waters
• Emily Ruth Webster, BCBA
• Whiddon Healthcare, Inc (Lincoln Chiropractic and Wellness Center)
• Joshua Andrew Whiddon, D. C.
• Misty Woods

• Family Nurse Practitioner in Lincoln, AL
• Providers in Lincoln, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; 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.