Individual provider Active NPI

Rachel A Wilcox, RN CNP

  • Nurse Practitioner
  • Benson, MN
National Provider Identifier
1639145402
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R0747282 Issued in MN
Practice address
1805 Wisconsin Ave
Benson, MN 56215
Phone
(320) 843-2030
Fax
(320) 314-1542
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R0747282 MN Primary

Addresses

Primary practice location

1805 Wisconsin Ave
Benson, MN 56215

Mailing address

1805 Wisconsin Ave
Benson, MN 56215
Phone (320) 843-2030

Other identifiers 1

IdentifierTypeStateIssuer
337483100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20051011000991 MN Practitioner - Nurse Practitioner 1254356991 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0747282MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Swift County-Benson Hospital CurrentSince Feb 20, 2017 Accepting new patients
Carris Health LLC Current Accepting new patients
Swift County Benson Hospital CurrentSince Feb 20, 2017 Accepting new patients
Great Plains Urology, PLLC Past Accepting new patients

Locations

1810 McKinney Ave
Benson, MN 56215
Phone (320) 843-2030

1815 Wisconsin Ave
Benson, MN 56215
Phone (320) 843-3454

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

Interoperability endpoints

  • Direct secure messaging: rwilcox436993@direct.centracare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1639145402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 WISCONSIN AVE",
            "city": "BENSON",
            "state": "MN",
            "postal_code": "56215",
            "telephone_number": "320-843-2030",
            "fax_number": "320-314-1542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 WISCONSIN AVE",
            "city": "BENSON",
            "state": "MN",
            "postal_code": "56215",
            "telephone_number": "320-843-2030",
            "fax_number": "320-314-1542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "RACHEL",
        "middle_name": "A",
        "credential": "RN CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R0747282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "337483100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benson, MN

Sources for this page

Verify at the official NPI Registry.