Amanda Jo Wilson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1003962 Issued in TX

Practice address

4507 Santa Rosa Dr
Midland, TX 79707-2260

Phone

(432) 683-8516

NPI assigned

Jul 17, 2020

Last updated

Jul 15, 2022By 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 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.wilson.1@24412.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/24412/brand/1/csg/1/fhir/r4

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.

• Midland Medicine PA

  • Internal Medicine Physician
  • Midland, TX
  • NPI 1346832771
  Medicare reassignment NPD
• Scotty Ortega MD LLP

  dba West Texas Medical Care

  • Family Medicine Physician
  • Odessa, TX
  • NPI 1194015297
  Medicare reassignment NPD
• Robert a Vogel MD PA

  • Internal Medicine Physician
  • Midland, TX
  • NPI 1609045707
  NPD (past)

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

{
    "created_epoch": "1594944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1609484419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4507 SANTA ROSA DR",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797072260",
            "telephone_number": "432-683-8516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4507 SANTA ROSA DR",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797072260",
            "telephone_number": "432-683-8516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "AMANDA",
        "middle_name": "JO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-17",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1003962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS NURSING BORARD",
            "identifier": "1003968",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amanda.wilson.1@24412.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4507 Santa Rosa Dr",
            "city": "Midland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "797072260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine Brawner Williamson, PA-C
• Lexie A Willingham, FNP
• Jennifer L. Willis, F.N.P.
• Cheryl Lynn Willoughby, MA, LPC
• Alexis D Wilson, LVN
• Arvel Andrew Wilson III, D.D.S.
• Blayke M Wilson
• Christopher Wilson, D.D.S.
• Lawrence A Wilson, MD
• Loretta Longoria Wilson

• Family Nurse Practitioner in Midland, TX
• Providers in Midland, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.