Active NPI
Cynthia Lynn Wilson, MAA
- In Home Supportive Care Agency
- Ottumwa, IA
National Provider Identifier
1578077830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- NONE
- Practice address
- 622 Overman Ave
Ottumwa, IA 52501-3949 - Phone
- (641) 799-8986
- NPI assigned
- Nov 24, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | NONE | IA | Primary |
Addresses
Primary practice location
622 Overman Ave
Ottumwa, IA 52501-3949
Mailing address
622 Overman Ave
Ottumwa, IA 52501-3949
Phone (641) 799-8986
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NONE | IA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511481600000",
"number": "1578077830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "622 OVERMAN AVE",
"city": "OTTUMWA",
"state": "IA",
"postal_code": "525013949",
"telephone_number": "641-799-8986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "622 OVERMAN AVE",
"city": "OTTUMWA",
"state": "IA",
"postal_code": "525013949",
"telephone_number": "641-799-8986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CYNTHIA",
"middle_name": "LYNN",
"credential": "MAA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-24",
"last_updated": "2017-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "IA",
"license": "NONE",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ottumwa, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.