Active NPI
Autumn Nicole Wilson, APRN
- Family Nurse Practitioner
- Poteau, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209703
- Practice address
- 105 Wall Street
Poteau, OK 74953 - Phone
- (918) 635-3576
- Fax
- (918) 635-3332
- NPI assigned
- Mar 31, 2023
- Last updated
- Mar 28, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209703 | OK | Primary |
Addresses
Primary practice location
105 Wall Street
Poteau, OK 74953
Mailing address
105 Wall Street
Poteau, OK 74953
Phone (918) 635-3576
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
304 Hwy 59 N
Heavener Medical Clinic
Heavener, OK 74937-2255
Phone (918) 653-2918
PO Box
Suite 689
Poteau, OK 74953
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209703 | OK | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Leflore County Hospital Authority | Current | Accepting new patients | |
| Leflore County Hospital Authority | Current | Accepting new patients | |
| Leflore County Hospital Authority | Current | Accepting new patients | |
| Stigler Health and Wellness Center Inc | Current | Accepting new patients | |
| Leflore County Hospital Authority | Past | Accepting new patients |
Locations
104 Wall St
Poteau, OK 74953
Phone (918) 635-3578
105 Wall St
Poteau, OK 74953
Phone (918) 635-3100
1630 S Kerr Blvd
Sallisaw, OK 74955
Phone (918) 790-2653
1505 E Main St
Stigler, OK 74462
Phone (800) 640-9741
Organizations & group practices 5
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.
-
dba Family Medical Clinic
- Rural Health Clinic/Center
- Poteau, OK
- NPI 1043265895
-
- Federally Qualified Health Center (FQHC)
- Stigler, OK
- NPI 1891752853
-
dba Heavener Medical Clinic
- Rural Health Clinic/Center
- Heavener, OK
- NPI 1558740837
-
dba Cavanal Medical Clinic
- Family Medicine Physician
- Poteau, OK
- NPI 1578026571
-
dba Eastern Oklahoma Medical Center
- Critical Access Hospital
- Poteau, OK
- NPI 1396767158
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Mountain Gateway Senior Health
- Psychiatric Hospital Unit
- Poteau, OK
- NPI 1184997447
-
dba Eastern Oklahoma Medical Center
- Critical Access Hospital
- Poteau, OK
- NPI 1396767158
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711584000000",
"number": "1639874662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 WALL STREET",
"city": "POTEAU",
"state": "OK",
"postal_code": "74953",
"telephone_number": "918-635-3576",
"fax_number": "918-635-3332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 WALL STREET",
"city": "POTEAU",
"state": "OK",
"postal_code": "74953",
"telephone_number": "918-635-3576",
"fax_number": "918-635-3332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "AUTUMN",
"middle_name": "NICOLE",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-31",
"last_updated": "2024-03-28",
"certification_date": "2022-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OK",
"license": "209703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Poteau, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.
- 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.