Individual provider Active NPI

Amber Nicole Wilcox, PA-C

  • Medical Physician Assistant
  • Terre Haute, IN
National Provider Identifier
1669026944
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10002776A Issued in IN
Practice address
2723 S 7TH St Ste a
Terre Haute, IN 47802-3558
Phone
(812) 232-8164
Fax
(812) 234-6391
NPI assigned
Jul 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10002776A IN Primary

Addresses

Primary practice location

2723 S 7TH St Ste a
Terre Haute, IN 47802-3558

Mailing address

2723 S 7TH St Ste a
Terre Haute, IN 47802-3558
Phone (812) 238-1730

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
I20190909000298 IN Practitioner - Physician Assistant 9830428473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical Group, LLCGroup PAC ID 9335135995, 27 clinicians

Practice addresses (Care Compare)

2229 Mary Sherman Dr
Sullivan, IN 47882-7633
Phone (812) 232-8164

2723 S 7TH St
Terre Haute, IN 47802-3558

2723 S 7TH St a
Terre Haute, IN 47802-3558

2723 S 7TH St C
Terre Haute, IN 47802-3558
Phone (812) 232-5936

Hospital & facility affiliations

  • Union Hospital Inc Hospital, Terre Haute, IN, CCN 150023
  • Sullivan County Community Hospital Hospital, Sullivan, IN, CCN 151327
  • Union Hospital Clinton Hospital, Clinton, IN, CCN 151326

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10002776AINMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital Inc. Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: awilcox@unionhealth.cernerdirect.com

Organizations & group practices 2

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 7

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": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1669026944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2723 S 7TH ST STE A",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478023558",
            "telephone_number": "812-238-1730",
            "fax_number": "812-242-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2723 S 7TH ST STE A",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478023558",
            "telephone_number": "812-232-8164",
            "fax_number": "812-234-6391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "AMBER",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-25",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10002776A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.