Active NPI
Kayci Dial Wilson, NURSE PRACTITIONER
- Family Nurse Practitioner
- Vivian, LA
National Provider Identifier
1720205586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP05072
- Practice address
- 815 S Pine St
Vivian, LA 71082-3353 - Phone
- (318) 375-3239
- Fax
- (318) 375-2755
- NPI assigned
- Apr 20, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP05072 | LA | Primary |
| Registered Nurse | 163W00000X | RN097383 | LA |
Addresses
Primary practice location
815 S Pine St
Vivian, LA 71082-3353
Mailing address
815 S Pine St
Vivian, LA 71082-3353
Phone (318) 375-3239
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2100360 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070511000515 | LA | Practitioner - Nurse Practitioner | 8123125929 | Reassigns benefits to 4 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Benton MedicalNorth Caddo Hospital Service District
Practice addresses (Care Compare)
188 Burt Blvd
Benton, LA 71006-4900
Phone (318) 965-5017
815 S Pine St
Vivian, LA 71082-3353
Phone (318) 375-3235
Hospital & facility affiliations
- North Caddo Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Caddo Hospital Service District | Current | Accepting new patients | |
| Benton Medical | Current | Accepting new patients | |
| North Caddo Hospital Service District | Current | Accepting new patients | |
| North Caddo Hospital Service District | Current | Accepting new patients | |
| South Bossier Medical | Past | Accepting new patients | |
| North Caddo Medical Center Community RX | Past | Accepting new patients | |
| North Caddo Medical Center | Past | Accepting new patients | |
| Advanced Cardiovascular Specialists | Past | Accepting new patients |
Locations
188 Burt Blvd
Benton, LA 71006
Phone (318) 965-1000
112 N Forrest Rd
Plain Dealing, LA 71064
Phone (318) 326-7272
5948 N Market St
Shreveport, LA 71107
Phone (318) 375-0001
815 S Pine St
Vivian, LA 71082
Phone (318) 375-3239
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/440a8ebc-db01-474a-8d18-2ca626c92c6c/
- kayciwilson@ncmc.allscriptsdirect.net
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 10
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.
-
- Critical Access Hospital
- Vivian, LA
- NPI 1417124959
-
- Rural Health Clinic/Center
- Vivian, LA
- NPI 1013181866
-
- Cardiovascular Disease Physician
- Shreveport, LA
- NPI 1881127090
-
- Rural Health Clinic/Center
- Oil City, LA
- NPI 1144063264
-
- Community/Retail Pharmacy
- Bossier City, LA
- NPI 1174315584
-
- Rural Health Clinic/Center
- Bossier City, LA
- NPI 1649993585
Hospital & facility affiliations 1
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": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760572800000",
"number": "1720205586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 S PINE ST",
"city": "VIVIAN",
"state": "LA",
"postal_code": "710823353",
"telephone_number": "318-375-3239",
"fax_number": "318-375-2755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 S PINE ST",
"city": "VIVIAN",
"state": "LA",
"postal_code": "710823353",
"telephone_number": "318-375-3239",
"fax_number": "318-375-2755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "KAYCI",
"middle_name": "DIAL",
"credential": "NURSE PRACTITIONER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-20",
"last_updated": "2025-10-16",
"certification_date": "2025-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "LA",
"license": "AP05072",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "LA",
"license": "RN097383",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2100360",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vivian, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; 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.