Individual provider Active NPI

Amy Diane Wilson

  • Family Nurse Practitioner
  • Columbus, IN
National Provider Identifier
1740764075
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71008369A Issued in IN
Practice address
3015 10TH St Ste a
Columbus, IN 47201-7091
Phone
(812) 372-8883
NPI assigned
Sep 22, 2018
Last updated
Mar 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71008369A IN Primary

Addresses

Primary practice location

3015 10TH St Ste a
Columbus, IN 47201-7091

Mailing address

PO Box 775383
Chicago, IL 60677-3728
Phone (812) 376-5315

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address awilson11703@edirect.crh.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20181004000329 IN Practitioner - Nurse Practitioner 8022360957 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2400 17TH St
Columbus, IN 47201-5351
Phone (812) 376-5974

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.97 of 100Reported as apm
Quality
85.1
Promoting interoperability
94.69
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71008369AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
FC Indiana, LLC CurrentSince Nov 29, 2018 Accepting new patients
Columbus Regional Health Physicians, LLC CurrentSince Sep 24, 2018 Accepting new patients
Columbus Regional Health Physicians, LLC CurrentSince Sep 24, 2018 Accepting new patients
FC Indiana, LLC CurrentSince Nov 29, 2018 Accepting new patients

Locations

2418 16th St
Bedford, IN 47421
Phone (812) 278-3154

2400 17th St
Columbus, IN 47201
Phone (812) 373-3025

2502 25th St
Columbus, IN 47201
Phone (812) 372-8883

3015 10th St
Ste A
Columbus, IN 47201
Phone (812) 372-8883

1202 E Tipton St
Seymour, IN 47274
Phone (812) 627-4933

Interoperability endpoints

  • Direct secure messaging: awilson11703@edirect.crh.org

Organizations & group practices 4

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.

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": "1537574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1740764075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775383",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606773728",
            "telephone_number": "812-376-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 10TH ST STE A",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472017091",
            "telephone_number": "812-372-8883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "AMY",
        "middle_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-22",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71008369A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awilson11703@edirect.crh.org",
            "affiliation": "N",
            "endpointDescription": "Diret Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "2502 25th St",
            "city": "Columbus",
            "state": "IN",
            "country_code": "US",
            "postal_code": "472013728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.