Sara Wilson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

8546685-4405 Issued in UT

Practice address

7777 S Redwood Rd
West Jordan, UT 84084-5518

Phone

(801) 966-1118

NPI assigned

Jun 1, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  Nurse Practitioner, UT

  Medicare reassignment NPD

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1689298085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 E MANSFIELD AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062123",
            "telephone_number": "801-734-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 S REDWOOD RD",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840845518",
            "telephone_number": "801-966-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-01",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "UT",
            "license": "8546685-3102",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "8546685-4405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "8546685-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://nursing.utah.edu/",
            "affiliation": "N",
            "endpointDescription": "College of Nursing",
            "address_1": "10 S 2000 E",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841125880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Willow Medella Wellness, LLC
• Kayla Wilson
• Makenna Wilson
• Matthew S Wilson, MD
• Preston Jon Wilson, D.O.
• Siobhan Wilson
• Dalton Winegar
• Richard Matthew Winn, DC
• Alan V Winter, RPH
• Steffani Anne Winter

• Family Nurse Practitioner in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.