Jodi Michelle Wilson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95016068 Issued in CA

Practice address

960 E Green St Ste 292
Pasadena, CA 91106-2401

Phone

(626) 449-4494

NPI assigned

Nov 23, 2020

Sex

Female

Sole proprietor

Yes

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 CA

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Craig R. Johnson, MD, Inc.Group PAC ID 2466405899, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jodi.wilson.p60@direct.healthcarepartners.nextgenshare.com

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.

• Craig R. Johnson, M.D., Inc.

  • Family Medicine Physician
  • Pasadena, CA
  • NPI 1578962825
  Medicare reassignment Care Compare group NPD
• American Current Care of California, a Medical Corporation

  dba Concentra Urgent Care

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1750573622
  Medicare reassignment NPD
• Dispatchhealth-Ca, PC

  • Emergency Medicine Physician
  • Tustin, CA
  • NPI 1639752553
  Medicare reassignment NPD
• Sierra Spring Family Wellness Center

  • Primary Care Clinic/Center
  • Pasadena, CA
  • NPI 1487788899
  NPD
• Professional Portable Radiologic Services Inc.

  • Physiological Laboratory
  • Houston, TX
  • NPI 1457087991
  NPD (past)

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1467056184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 E GREEN ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911062422",
            "telephone_number": "626-840-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 E GREEN ST STE 292",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911062401",
            "telephone_number": "626-449-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JODI",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-23",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95016068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donny V. Wilson
• Erika Elyse Wilson
• Gina M Wilson, M.S.
• Janet Wilson, LCSW
• Jerome Lamon Wilson
• Julia Wilson, PA
• Kayla Soriya Wilson
• Lindsay Wilson
• Marcia Huipe Wilson, PH.D.
• Margie Ann Wilson

• Family Nurse Practitioner in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.