Individual provider Active NPI

Jessica Marie Wight, FNP-C

  • Family Nurse Practitioner
  • Willow Park, TX
National Provider Identifier
1518503259
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP139685 Issued in TX
Practice address
260 Willow Bend Dr
Willow Park, TX 76008-1276
Phone
(817) 441-9252
Fax
(817) 441-9282
NPI assigned
Nov 18, 2019
Last updated
Jan 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP139685 TX Primary

Addresses

Primary practice location

260 Willow Bend Dr
Willow Park, TX 76008-1276

Mailing address

260 Willow Bend Dr
Willow Park, TX 76008-1276
Phone (817) 441-9252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220223000367 TX Practitioner - Nurse Practitioner 4183018880 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shaun Kretzschmar DO PAGroup PAC ID 6800192212, 3 clinicians

Practice addresses (Care Compare)

260 Willow Bend Dr
Medical Associates at Willow Park
Aledo, TX 76008-1188
Phone (817) 441-9252

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP139685TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Segue Health of Texas PLLC CurrentSince Feb 1, 2022 Accepting new patients
Shaun Kretzschmar DO PA CurrentSince Feb 4, 2024 Accepting new patients
Oakridge Urgent Care, PLLC PastSince Nov 1, 2019 Accepting new patients
Matthew G. Stine, D.O., P.a. PastSince Jan 15, 2023 Accepting new patients

Locations

317 N FM 1187
Aledo, TX 76008
Phone (817) 441-7181

260 Willow Bend Dr
Willow Park, TX 76008
Phone (817) 441-2555

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1518503259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 WILLOW BEND DR",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760081276",
            "telephone_number": "817-441-9252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 WILLOW BEND DR",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760081276",
            "telephone_number": "817-441-9252",
            "fax_number": "817-441-9282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGHT",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Park, TX

Sources for this page

Verify at the official NPI Registry.