Jaime L Wilson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

23066 Issued in TN

Practice address

1 Medical Park Blvd Ste 458W
Bristol, TN 37620-7456

Phone

(423) 844-4800

Fax

(423) 230-6905

NPI assigned

Jun 21, 2017

Last updated

Aug 21, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Abingdon Physician PartnersGroup PAC ID 5991705667, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Russell County Hospital Hospital, Lebanon, VA, CCN 490002
• Johnston Memorial Hospital Hospital, Abingdon, VA, CCN 490053

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Abingdon Physician Partners

  • Internal Medicine Physician
  • Abingdon, VA
  • NPI 1306944350
  Medicare reassignment Care Compare group NPD
• Wellmont Medical Associates, Inc.

  dba Ballad Health Medical Associates

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1154789030
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Johnston Memorial Hospital, Inc

  • General Acute Care Hospital
  • Abingdon, VA
  • NPI 1104812684
  Care Compare affiliation
• Mountain States Health Alliance

  dba Russell County Hospital

  • General Acute Care Hospital
  • Lebanon, VA
  • NPI 1891973939
  Care Compare affiliation

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503273600000",
    "number": "1538689542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W STONE DR STE 6A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603256",
            "telephone_number": "423-408-7220",
            "fax_number": "423-408-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD STE 458W",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207456",
            "telephone_number": "423-844-4800",
            "fax_number": "423-230-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JAIME",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2017-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "23066",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001204968",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy L Willocks
• Wilson Pharmacy, Inc. (Ballad Health Pharmacy at Bristol)
• Anna Lee Wilson
• Donovan Dean Wilson
• Earl Keith Wilson, MD
• Margery A Wilson, FNP
• Margie B Wilson, CMSW
• Myron Keith Wilson, DDS
• Gary Austin Wishart, PSYD
• Jill Anne Rubin Wishart, LCSW DCSW

• Family Nurse Practitioner in Bristol, TN
• Providers in Bristol, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2017; 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.