Amber K Wilson, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201702462NP-PP Issued in OR

Practice address

18840 SW Boones Ferry Rd
Tualatin, OR 97062-9594

Phone

(503) 427-2394

NPI assigned

Apr 7, 2017

Last updated

Apr 7, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mindful MattersGroup PAC ID 7911287305, 6 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mindful Matters

  • Psychiatric/Mental Health Nurse Practitioner
  • Gulfport, MS
  • NPI 1477003028
  Medicare reassignment Care Compare group
• North Plantation

  dba Mindful Matters

  • Child & Adolescent Psychiatry Physician
  • Gulfport, MS
  • NPI 1639620560
  NPD

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1730612540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18840 SW BOONES FERRY RD",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18840 SW BOONES FERRY RD",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629594",
            "telephone_number": "503-427-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "AMBER",
        "middle_name": "K",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-07",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201702462NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willamette Hematology-Oncology PC
• Willamette Orthotics & Prosthetics LLC (Summit Orthotics and Prosthetics)
• Willglow Psychiatry and Wellness Services
• Sandi Dawn Williams, CSWA
• Gregory S Willis, M.D.
• Tammy Leigh Wilson, PA-C
• Thomas G Wimmer, MD
• Courtney Rose Winn, RN
• Janell Elizabeth Wismer, SLP
• Donald William Wissusik, M.A., M.S.

• Psychiatric/Mental Health Nurse Practitioner in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; 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.

Verify at the official NPI Registry.