Jane Gallaudet Wilson, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP131041 Issued in ME

Practice address

114 Bath Rd
Brunswick, ME 04011-2606

Phone

(207) 798-4400

Fax

(207) 798-4452

NPI assigned

Dec 6, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ME

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5857/brand/1/csg/1/fhir/r4
• Direct secure messaging: jane.wilson.1@5857.direct.athenahealth.com

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.

• Martin'S Point Health Care, Inc.

  • Family Medicine Physician
  • Portland, ME
  • NPI 1366474611
  Medicare reassignment NPD

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1760813430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9746",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041045040",
            "telephone_number": "207-799-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 BATH RD",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112606",
            "telephone_number": "207-798-4400",
            "fax_number": "207-798-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JANE",
        "middle_name": "GALLAUDET",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-06",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ME",
            "license": "RN59802",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP131041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jane.wilson.1@5857.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "114 Bath Rd",
            "city": "Brunswick",
            "state": "ME",
            "country_code": "US",
            "postal_code": "040112606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William Wilkoff, MD
• William L. Rolfe, LCSW, LLC
• Renee D. Williams, LCSW
• Craig Lee Williamson, MS OT
• Alexandra Logan Wilson, M.D.
• Kimberly Brann Wilson, LCSW
• Santana M Wilson, LATC
• William R Wink, CRNA
• Kathleen S. Winn, D.M.D.
• Wise Star Counseling LLC

• Family Nurse Practitioner in Brunswick, ME
• Providers in Brunswick, ME by specialty
• Family Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.