Individual provider Active NPI

Lauren Wilson, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1477115442
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1130484 Issued in KY
Practice address
1030 Monarch St Ste 100
Lexington, KY 40513-1820
Phone
(859) 296-3141
NPI assigned
Jul 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1130484 KY Primary

Addresses

Primary practice location

1030 Monarch St Ste 100
Lexington, KY 40513-1820

Mailing address

1030 Monarch St Ste 100
Lexington, KY 40513-1820
Phone (859) 296-3141

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191213000587 KY Practitioner - Nurse Practitioner 1557794070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

Practice addresses (Care Compare)

1030 Monarch St
Suite 100
Lexington, KY 40513-1820
Phone (844) 468-5050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1130484KYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological & Behavioral Consultants, LLC CurrentSince Oct 13, 2019 Accepting new patients
Beaumont Behavioral Health PSC Psychiatric/Mental Health Past Accepting new patients

Locations

120 Prosperous Pl
Ste 201
Lexington, KY 40509
Phone (859) 368-0609

1030 Monarch St
Ste 100
Lexington, KY 40513
Phone (844) 468-5050

100 Executive Park
Ste 103
Louisville, KY 40207
Phone (502) 313-6880

Interoperability endpoints

  • Direct secure messaging: bbh.laurenwilson@140103.advancedmd-direct.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1477115442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 MONARCH ST STE 100",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131820",
            "telephone_number": "859-296-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 MONARCH ST STE 100",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131820",
            "telephone_number": "859-296-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LAUREN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "1130484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.