Jennifer Wilcox, RN

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

6174761 Issued in NY

Practice address

689 E Jericho Tpke
Huntington Station, NY 11746-7501

Phone

(631) 854-4400

Fax

(631) 854-4436

NPI assigned

Oct 4, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• County of Suffolk

  • Methadone Clinic
  • Smithtown, NY
  • NPI 1649374851
  NPD (past)
• County of Suffolk

  • Methadone Clinic
  • Huntington Station, NY
  • NPI 1891897781
  NPD (past)

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1558645978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "689 E JERICHO TPKE",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117467501",
            "telephone_number": "631-854-4400",
            "fax_number": "631-854-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "689 E JERICHO TPKE",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117467501",
            "telephone_number": "631-854-4400",
            "fax_number": "631-854-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "JENNIFER",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-04",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "6174761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Watral, CPNP
• Jacqueline A Watson, LPN
• Mark Richard Wax
• Ianina Wentinck, MS-SLP
• Tajirah M Whyte
• Christopher Wilkinson, DPM
• Regina Nicole Williams, RN
• Tajiddin James Williams
• Steven G. Wishner, MD
• Leslie Jean Wissner, RN

• Addiction (Substance Use Disorder) Registered Nurse in Huntington Station, NY
• Providers in Huntington Station, NY by specialty
• Addiction (Substance Use Disorder) Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.