Cameran Rachelle Wilson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

191477-4405 Issued in UT

Practice address

5896 S Ridgeline Dr Ste B
South Ogden, UT 84405-4928

Phone

(801) 866-0170

Fax

(801) 866-0169

NPI assigned

Aug 1, 2019

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

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in UT, WY2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Revere Health PCGroup PAC ID 7517868508, 407 clinicians

North Lincoln County Hospital DistrictGroup PAC ID 4789580218, shared by 4 NPIs, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Star Valley Medical Center Hospital, Afton, WY, CCN 531313

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cameranwilson@cuccu.allscriptsdirect.net

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.

• Revere Health PC

  • Multi-Specialty Clinic/Center
  • Provo, UT
  • NPI 1093764805
  Medicare reassignment Care Compare group NPD
• North Lincoln County Hospital District

  • Critical Access Hospital
  • Afton, WY
  • NPI 1255376406
  Medicare reassignment
• North Lincoln County Hospital District

  • Family Medicine Physician
  • Afton, WY
  • NPI 1730132523
  Medicare reassignment
• Revere Health PC

  • Multi-Specialty Clinic/Center
  • Spanish Fork, UT
  • NPI 1851142285
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Lincoln County Hospital District

  • Critical Access Hospital
  • Afton, WY
  • NPI 1255376406
  Care Compare affiliation

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1730734203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "address_2": "ATT: CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84604",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5896 S RIDGELINE DR STE B",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844054928",
            "telephone_number": "801-866-0170",
            "fax_number": "801-866-0169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "950 S 500 W Ste 103",
            "address_purpose": "LOCATION",
            "city": "Brigham City",
            "state": "UT",
            "postal_code": "843024719",
            "country_code": "US",
            "telephone_number": "801-866-0170",
            "fax_number": "801-866-0169",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2850 N 2000 W Ste 201",
            "address_purpose": "LOCATION",
            "city": "Farr West",
            "state": "UT",
            "postal_code": "844049230",
            "country_code": "US",
            "telephone_number": "801-866-0170",
            "fax_number": "801-866-0169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CAMERAN",
        "middle_name": "RACHELLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-01",
        "last_updated": "2023-11-27",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "191477-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Revere Health PC",
            "address_1": "950 S 500 W Ste 103",
            "city": "Brigham City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "843024719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Revere Health PC",
            "address_1": "5896 S Ridgeline Dr Ste B",
            "city": "South Ogden",
            "state": "UT",
            "country_code": "US",
            "postal_code": "844054928",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Revere Health PC",
            "address_1": "2850 N 2000 W Ste 201",
            "city": "Farr West",
            "state": "UT",
            "country_code": "US",
            "postal_code": "844049230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Charlene Wichman
• Korryn Wiese, P.T., C.M.P.T.
• Willard Z Maughan M.D. P.C.
• Sianeh Williams-Geddings, RBT
• Michael Williams, RBT
• Makenzie Baird Womack
• Matthew Paul Wood, D.C.
• Braken Wooden, D.C.
• Wesley Van Wooden, DC
• Dale A Woodfield, O.D.

• Family Nurse Practitioner in South Ogden, UT
• Providers in South Ogden, 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 Nov 27, 2023; 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.