Individual provider Active NPI

Jodie Wilson

  • General Practice Registered Nurse
  • Canal Winchester, OH
National Provider Identifier
1619793734
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
RN441776 Issued in OH
Practice address
4011 Sophie Pearl LN
Canal Winchester, OH 43110-3548
Phone
(614) 441-5339
NPI assigned
Nov 25, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WG0000X RN441776 OH Primary

Addresses

Primary practice location

4011 Sophie Pearl LN
Canal Winchester, OH 43110-3548

Mailing address

4011 Sophie Pearl LN
Canal Winchester, OH 43110-3548
Phone (614) 441-5339

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

LicenseStateTypeSpecialty
RN441776OHMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1619793734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 SOPHIE PEARL LN",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431103548",
            "telephone_number": "614-441-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 SOPHIE PEARL LN",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431103548",
            "telephone_number": "614-441-5339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JODIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": "OH",
            "license": "RN441776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canal Winchester, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.