Individual provider Active NPI

Jennifer Marie Wilson, CRNA

  • Certified Registered Nurse Anesthetist
  • High Point, NC
National Provider Identifier
1639453285
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
088367 Issued in NC
Practice address
401 Ferndale Blvd
High Point, NC 27262-4739
Phone
(336) 882-2567
NPI assigned
Sep 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 088367 NC Primary

Addresses

Primary practice location

401 Ferndale Blvd
High Point, NC 27262-4739

Mailing address

PO Box 2168
High Point, NC 27261-2168
Phone (336) 882-2567

Other identifiers 1

IdentifierTypeStateIssuer
8054107MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111129000077 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486828696 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke University Health System, IncGroup PAC ID 2567372345, 1,083 clinicians

Practice addresses (Care Compare)

2301 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111

Hospital & facility affiliations

  • Duke University Hospital Hospital, Durham, NC, CCN 340030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
088367NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Jul 31, 2023 Accepting new patients
Piedmont Triad Anesthesia, PA Anesthesiology CurrentSince Jun 1, 2013 Accepting new patients
Regional Anesthesia, PLLC CurrentSince Aug 7, 2017 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Oct 20, 2020 Accepting new patients
Eagle Physicians and Associates PA Current Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Jul 31, 2023 Accepting new patients
The Moses H. Cone Memorial Hospital Operating Corporation Current Accepting new patients
Carolina Anesthesiology, PA Anesthesiology CurrentSince Dec 1, 2011 Accepting new patients
Eagle Physicians and Associates PA CurrentSince Sep 1, 2022 Accepting new patients
Duke University Health System, Inc. CurrentSince Jul 14, 2020 Accepting new patients
Duke University Health System, Inc. Nurse Anesthetist, Certified Registered CurrentSince Jul 14, 2020 Accepting new patients
Eagle Physicians and Associates PA CurrentSince Sep 1, 2022 Accepting new patients

Locations

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

401 Ferndale Blvd
High Point, NC 27262
Phone (336) 882-2567

3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

618 S Main St
Reidsville, NC 27320
Phone (336) 832-7965

145 Kimel Park Dr
Ste 120
Winston Salem, NC 27103
Phone (336) 277-1770

Organizations & group practices 12

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.

Hospital & facility affiliations 6

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": "1317340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1639453285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2168",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272612168",
            "telephone_number": "336-882-2567",
            "fax_number": "336-882-5466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 FERNDALE BLVD",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272624739",
            "telephone_number": "336-882-2567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-30",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "088367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8054107",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.