Active NPI
Joanne M Wilson, A.P.N.
- Pediatric Nurse Practitioner
- North Little Rock, AR
National Provider Identifier
1669582995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- A01075
- Practice address
- 3401 Springhill Dr
Suite 245
North Little Rock, AR 72117-2924 - Phone
- (501) 758-1530
- Fax
- (501) 758-5371
- NPI assigned
- Aug 30, 2006
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | A01075 | AR | Primary |
Addresses
Primary practice location
3401 Springhill Dr
Suite 245
North Little Rock, AR 72117-2924
Mailing address
3401 Springhill Dr
Suite 245
North Little Rock, AR 72117-2924
Phone (501) 758-1530
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R16871 | Other | AR | REGISTERED NURSE |
| A01075 | Other | AR | ADVANCED PRACTICE NURSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| A01075 | AR | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Pediatric Clinic of NLR, P.a. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Medical Specialty Clinic/Center
- Sherwood, AR
- NPI 1588692198
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669582995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 SPRINGHILL DR",
"address_2": "SUITE 245",
"city": "NORTH LITTLE ROCK",
"state": "AR",
"postal_code": "721172924",
"telephone_number": "501-758-1530",
"fax_number": "501-758-5371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 SPRINGHILL DR",
"address_2": "SUITE 245",
"city": "NORTH LITTLE ROCK",
"state": "AR",
"postal_code": "721172924",
"telephone_number": "501-758-1530",
"fax_number": "501-758-5371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JOANNE",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "A.P.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "AR",
"license": "A01075",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED NURSE",
"identifier": "R16871",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADVANCED PRACTICE NURSE",
"identifier": "A01075",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.