Individual provider Active NPI

Jennifer Leigh Wilson, F.N.P.

  • Family Nurse Practitioner
  • Fredericksburg, VA
National Provider Identifier
1558517136
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024167920 Issued in VA
Practice address
418 Chatham Square Office Park Ste 200
Fredericksburg, VA 22405-2561
Phone
(540) 371-4800
NPI assigned
Aug 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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 0024167920 VA Primary

Addresses

Primary practice location

418 Chatham Square Office Park Ste 200
Fredericksburg, VA 22405-2561

Mailing address

120 Executive Center Pkwy
Fredericksburg, VA 22401-3100
Phone (540) 374-5200

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090212000545 VA Practitioner - Nurse Practitioner 9133284847 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Embracing Health, Inc.Group PAC ID 6608051883, 5 clinicians

Practice addresses (Care Compare)

385 Garrisonville Rd
Stafford, VA 22554-8900

385 Garrisonville Rd
Suite 121
Stafford, VA 22554-1545

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Physicians CurrentSince Nov 1, 2020 Accepting new patients
Mary Washington Healthcare Physicians CurrentSince Nov 1, 2020 Accepting new patients
Embracing Health, Inc. Family CurrentSince May 7, 2025 Accepting new patients
Primary and Urgent Care LLC Past Accepting new patients

Locations

120 Executive Center Pkwy
Fredericksburg, VA 22401
Phone (540) 374-5097

418 Chatham Square Office Park
Ste 200
Fredericksburg, VA 22405
Phone (540) 371-4800

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

422 Garrisonville Rd
Ste 102
Stafford, VA 22554
Phone (540) 657-4800

385 Garrisonville Rd
Ste 121
Stafford, VA 22554
Phone (540) 318-8602

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18689/brand/1/csg/1/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 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": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1558517136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 EXECUTIVE CENTER PKWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013100",
            "telephone_number": "540-374-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 CHATHAM SQUARE OFFICE PARK STE 200",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224052561",
            "telephone_number": "540-371-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-14",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024167920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.