Individual provider Active NPI

Tiffany Celeste Wilson, NP-C

  • Family Nurse Practitioner
  • Searcy, AR
National Provider Identifier
1740765205
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A005849 Issued in AR
Practice address
400 S Main St Ste 100
Searcy, AR 72143-7801
Phone
(501) 368-0132
Fax
(501) 368-0123
NPI assigned
Oct 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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 A005849 AR Primary

Addresses

Primary practice location

400 S Main St Ste 100
Searcy, AR 72143-7801

Mailing address

400 S Main St Ste 100
Searcy, AR 72143-7801
Phone (501) 368-0132

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20200327002123 AR Practitioner - Nurse Practitioner 0840629747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

205 Westport Dr
1 Baptist Health Family Clinic Cabot
Cabot, AR 72023-3657
Phone (501) 843-6585

Hospital & facility affiliations

  • Elite Home Health Home health agency, Little Rock, AR, CCN 047028
  • Baptist Health Home Health-LR Home health agency, Little Rock, AR, CCN 047090
  • Unity Health Home Homecare Home health agency, Searcy, AR, CCN 047035
  • Baptist Health Medical Center-Little Rock Hospital, Little Rock, AR, CCN 040114
  • Baptist Health Medical Center North Little Rock Hospital, North Little Rock, AR, CCN 040036
  • Baptist Health Rehabilitation Institute Inpatient rehabilitation facility, Little Rock, AR, CCN 043026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A005849ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group CurrentSince Nov 9, 2020 Accepting new patients
Arkansas Health Group CurrentSince Nov 9, 2020 Accepting new patients
Arkansas Health Group Past Accepting new patients

Locations

205 Westport Dr
Ste 1
Cabot, AR 72023
Phone (501) 843-6585

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

Interoperability endpoints

  • Direct secure messaging: twilson269539@direct.baptist-healthar.org

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1740765205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S MAIN ST STE 100",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721437801",
            "telephone_number": "501-368-0132",
            "fax_number": "501-368-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S MAIN ST STE 100",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721437801",
            "telephone_number": "501-368-0132",
            "fax_number": "501-368-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TIFFANY",
        "middle_name": "CELESTE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Searcy, AR

Sources for this page

Verify at the official NPI Registry.