NPIMap

Individual provider Active NPI

Jennifer M Wilson, MD

  • Emergency Medicine Physician
  • Reno, NV
National Provider Identifier
1477588432
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
10019 Issued in NV
Practice address
235 W 6TH St
Reno, NV 89503-4548
Phone
(775) 770-3188
Fax
(775) 770-3588
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 10019 NV Primary

Addresses

Primary practice location

235 W 6TH St
Reno, NV 89503-4548

Mailing address

PO Box 21418
Reno, NV 89515-1418
Phone (775) 746-3202

Other identifiers 1

IdentifierTypeStateIssuer
002016938MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040305000784 NV Practitioner - Emergency Medicine 7618876046 Reassigns benefits to 1 organization
I20130128000415 CA Practitioner - Emergency Medicine 7618876046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Johns Hopkins University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reno Emergency Physicians Association PLLCGroup PAC ID 6305745738, 13 clinicians

Practice addresses (Care Compare)

235 W 6TH St
Reno, NV 89503-4548
Phone (775) 770-5188

Hospital & facility affiliations

  • Saint Mary'S Regional Medical Center Hospital, Reno, NV, CCN 290009
  • Tahoe Forest Hospital Hospital, Truckee, CA, CCN 051328

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Reno Emergency Physicians Association, PLLC Emergency Medicine CurrentSince Jan 18, 2002 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jan 1, 2013 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jan 1, 2013 Accepting new patients
Churchill Mangat Emergency Group PC Emergency Medicine Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

2801 L St
Sacramento, CA 95816
Phone (916) 454-2222

10121 Pine Ave
Truckee, CA 96161
Phone (530) 582-3220

235 W 6th St
Reno, NV 89503
Phone (775) 746-3202

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Saint Mary'S Regional Medical CenterReno, NV, CCN 290009 Hospital Corporate Director Jan 1, 2014

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1477588432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21418",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895151418",
            "telephone_number": "775-746-3202",
            "fax_number": "775-770-3588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 W 6TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034548",
            "telephone_number": "775-770-3188",
            "fax_number": "775-770-3588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "10019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002016938",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.