Individual provider Active NPI

Joshua Bryan Wilson Sr., NP

  • Nurse Practitioner
  • Denver, CO
National Provider Identifier
1528503885
Registry record updated Sep 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
201609976NP-PP Issued in OR
Practice address
777 Bannock St
Denver, CO 80204-4507
Phone
(720) 336-3791
NPI assigned
Dec 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 201609976NP-PP OR Primary

Addresses

Primary practice location

777 Bannock St
Denver, CO 80204-4507

Mailing address

7105 Battle Mountain Rd
Colorado Springs, CO 80922-1215
Phone (801) 425-7398

Other practice location 1

375 Park Ave Ste 5
Coos Bay, OR 97420-2242
Phone (541) 267-7543

Other practice location 2

1793 13th St SE
Salem, OR 97302-2541
Phone (503) 362-8385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20211124001547 CO Practitioner - Nurse Practitioner 9638451412 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rational Dermatology, PCGroup PAC ID 4385775204, 11 clinicians

Practice addresses (Care Compare)

1220 Lake Plaza Dr
Colorado Springs, CO 80906-3548
Phone (719) 531-5400

8580 Scarborough Dr
Suite 225
Colorado Springs, CO 80920-7586
Phone 7195315400100

Merit-based Incentive Payment System (MIPS)

Final score
84.08 of 100Reported as group
Quality
81.46
Improvement activities
40
Cost
71.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201609976NP-PPORMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Sep 3, 2021 Accepting new patients
Denver Health and Hospital Authority CurrentSince Sep 3, 2021 Accepting new patients
Rational Dermatology, PC Dermatology Current Accepting new patients
Rational Dermatology, PC Dermatology CurrentSince Jun 15, 2022 Accepting new patients

Locations

8580 Scarborough Dr
Ste 225
Colorado Springs, CO 80920
Phone (719) 531-5400

1220 Lake Plaza Dr
Colorado Springs, CO 80906
Phone (719) 531-5400

777 Bannock St
Denver, CO 80204

Interoperability endpoints

  • Direct secure messaging: jwilson257037@direct.dhha.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630886400000",
    "number": "1528503885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7105 BATTLE MOUNTAIN RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809221215",
            "telephone_number": "801-425-7398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044507",
            "telephone_number": "720-336-3791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "375 Park Ave Ste 5",
            "address_purpose": "LOCATION",
            "city": "Coos Bay",
            "state": "OR",
            "postal_code": "974202242",
            "country_code": "US",
            "telephone_number": "541-267-7543",
            "fax_number": "503-362-8435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1793 13th St SE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973022541",
            "country_code": "US",
            "telephone_number": "503-362-8385",
            "fax_number": "503-362-8435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JOSHUA",
        "middle_name": "BRYAN",
        "name_suffix": "Sr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-22",
        "last_updated": "2021-09-06",
        "certification_date": "2021-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201609976NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.