Micah James Wilson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

201150063NP Issued in OR

Practice address

1050 SW 3Rd Ave
Ste 3200
Ontario, OR 97914-2193

Phone

(541) 881-7370

Fax

(541) 881-7379

NPI assigned

Jul 8, 2011

Last updated

Jul 8, 2011By the provider in NPPES

Sex

Male

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 AL

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

USA Health Community Providers LLCGroup PAC ID 2062875479, 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• USA Health University Hospital Hospital, Mobile, AL, CCN 010087

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• USA Health Community Providers LLC

  • Family Medicine Physician
  • Mobile, AL
  • NPI 1801571823
  Medicare reassignment Care Compare group NPD
• University of South Alabama Health Care Authority

  • Internal Medicine Physician
  • Mobile, AL
  • NPI 1508392432
  NPD

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

• University of South Alabama

  dba USA Health University Hospital

  • General Acute Care Hospital
  • Mobile, AL
  • NPI 1063468072
  Care Compare affiliation
• University of South Alabama

  dba USA Health Reference Lab Billing

  • General Acute Care Hospital
  • Mobile, AL
  • NPI 1972138022
  Care Compare affiliation

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310083200000",
    "number": "1760779904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 SW 3RD AVE",
            "address_2": "STE 3200",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979142193",
            "telephone_number": "541-881-7370",
            "fax_number": "541-881-7379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 SW 3RD AVE",
            "address_2": "STE 3200",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979142193",
            "telephone_number": "541-881-7370",
            "fax_number": "541-881-7379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICAH",
        "middle_name": "JAMES",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-08",
        "last_updated": "2011-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201150063NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Channa Rae Williams
• Stephanie Williams
• Brandye Wilson-Manigat, M.D.
• Ashley Wilson, CADC-R
• Kimberly Wilson, RDH
• Tammie Jean Wilson, LPC
• Mark Wiseman
• Emily Renee Wittenberg
• Jayna Witty
• Sidni Wolery

• Nurse Practitioner in Ontario, OR
• Providers in Ontario, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; 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.