Individual provider Active NPI

Jennifer Ann Wilson, MD

  • Family Medicine Physician
  • Napa, CA
National Provider Identifier
1558378984
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A86620 Issued in CA
Practice address
300 Hartle CT
Napa, CA 94559-4078
Phone
(707) 254-1775
Fax
(707) 251-1779
NPI assigned
Aug 1, 2006
Last updated
Feb 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A86620 CA Primary

Addresses

Primary practice location

300 Hartle CT
Napa, CA 94559-4078

Mailing address

1141 Pear Tree LN Ste 100
Napa, CA 94558-6485
Phone (707) 254-1770

Other practice location 1

1141 Pear Tree Lane
Suite 100
Napa, CA 94558
Phone (707) 254-1770

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070125000158 CA Practitioner - Family Practice 4688675119 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A86620CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ole Health CurrentSince Jul 1, 2006 Accepting new patients
Ole Health CurrentSince Jul 1, 2006 Accepting new patients
Ole Health Past Accepting new patients
Ole Health Past Accepting new patients
Ole Health Past Accepting new patients
Ole Health Past Accepting new patients
Ole Health Past Accepting new patients
Ole Health Past Accepting new patients
Ole Health Past Accepting new patients
Ole Health Past Accepting new patients
Ole Health Past Accepting new patients
Ole Health Past Accepting new patients
Ole Health Past Accepting new patients
Ole Health Past Accepting new patients

Locations

1327 Berry St
Calistoga, CA 94515
Phone (707) 254-1775

1100 Trancas St
Ste 300
Napa, CA 94558
Phone (707) 257-4084

1141 Pear Tree Ln
Ste 100
Napa, CA 94558
Phone (707) 254-1778

300 Hartle Ct
Napa, CA 94559
Phone (707) 254-1775

Interoperability endpoints

  • Direct secure messaging: jwilson676156@direct.ochin.org

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1558378984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 PEAR TREE LN STE 100",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945586485",
            "telephone_number": "707-254-1770",
            "fax_number": "707-254-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HARTLE CT",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945594078",
            "telephone_number": "707-254-1775",
            "fax_number": "707-251-1779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1141 Pear Tree Lane",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Napa",
            "state": "CA",
            "postal_code": "94558",
            "country_code": "US",
            "telephone_number": "707-254-1770",
            "fax_number": "707-251-2993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A86620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Napa, CA

Sources for this page

Verify at the official NPI Registry.