Individual provider Active NPI

Cacia L Wilson

  • Family Nurse Practitioner
  • Lafayette, IN
National Provider Identifier
1619362076
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71005451A Issued in IN
Practice address
3750 Landmark Dr Ste a
Lafayette, IN 47905-6652
Phone
(765) 448-4511
Fax
(765) 447-7312
NPI assigned
Apr 2, 2015
Last updated
Mar 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71005451A IN Primary
Registered Nurse 163W00000X 28195527A IN

Addresses

Primary practice location

3750 Landmark Dr Ste a
Lafayette, IN 47905-6652

Mailing address

3750 Landmark Dr Ste a
Lafayette, IN 47905-6652
Phone (765) 448-4511

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cacia.wilsonnp.p8@direct.ahni.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20150518001338 IN Practitioner - Nurse Practitioner 9739409681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10995 Allisonville Rd
Suite 100
Fishers, IN 46038-2616
Phone (317) 842-7928

3309 S 750
Russiaville, IN 46979-9146
Phone (765) 883-2273

3743 Landmark Dr
Suite 200
Lafayette, IN 47905-6656
Phone (765) 448-4511

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28195527AINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
American Health Network of Indiana LLC CurrentSince Sep 3, 2019 Accepting new patients
American Health Network of Indiana, LLC CurrentSince Sep 3, 2019 Accepting new patients
American Health Network of Indiana, LLC Past Accepting new patients

Locations

10689 N Pennsylvania St
Ste 200
Carmel, IN 46280
Phone (317) 580-6309

10995 Allisonville Rd
Ste 100
Fishers, IN 46038
Phone (317) 842-7928

7440 Woodland Dr
Indianapolis, IN 46278
Phone (317) 450-3357

3743 Landmark Dr
Ste 200
Lafayette, IN 47905
Phone (765) 448-4511

3750 Landmark Dr
Ste A
Lafayette, IN 47905
Phone (765) 448-4511

Interoperability endpoints

  • Direct secure messaging: cacia.wilsonnp.p8@direct.ahni.nextgenshare.com
  • Direct secure messaging: cwilson211487@direct.optum.com

Organizations & group practices 3

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": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1619362076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 LANDMARK DR STE A",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479056652",
            "telephone_number": "765-448-4511",
            "fax_number": "765-447-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 LANDMARK DR STE A",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479056652",
            "telephone_number": "765-448-4511",
            "fax_number": "765-447-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CACIA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71005451A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28195527A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cacia.wilsonnp.p8@direct.ahni.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3750 Landmark Dr Ste A",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479056652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.