Individual provider Active NPI

Haley Nevels Wilson, AGACNP-BC, FNP-BC

  • Acute Care Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1780237859
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
34000 Issued in TN
Practice address
2525 Desales Ave Ste F1009
Chattanooga, TN 37404-1161
Phone
(423) 697-2000
Fax
(423) 697-2320
NPI assigned
Jul 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-127930 AL
Family Nurse Practitioner 363LF0000X 1-127930 AL
Acute Care Nurse Practitioner 363LA2100X 34000 TN Primary

Addresses

Primary practice location

2525 Desales Ave Ste F1009
Chattanooga, TN 37404-1161

Mailing address

2501 Citico Ave
Chattanooga, TN 37404-1127
Phone (423) 697-2000

Other practice location 1

201 Sivley Rd SW Ste 500
Huntsville, AL 35801-5177
Phone (256) 265-3880

Other names 1

  • Mrs. Haley Brooke Nevels Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20230713002077 TN Practitioner - Nurse Practitioner 9133589898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Health Care System Inc.Group PAC ID 8628978210, 56 clinicians

Practice addresses (Care Compare)

2501 Citico Ave
Chattanooga, TN 37404-1127
Phone (423) 697-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
92.6
Promoting interoperability
93.23
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34000TNMDEmergency Medicine Physician
1-127930ALMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Health Care System Inc. Current Accepting new patients
Cardiovascular Group, PC Current Accepting new patients
Memorial Health Care System, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Healthcare Authority of the City of Huntsville Hospitalist PastSince Jul 25, 2019 Accepting new patients

Locations

2501 Citico Ave
Chattanooga, TN 37404
Phone (423) 697-2318

2525 Desales Ave
Ste F1009
Chattanooga, TN 37404
Phone (423) 624-5200

Interoperability endpoints

  • Direct secure messaging: haley.wilson@direct.chattanoogaheart.nextgenshare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1780237859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CITICO AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041127",
            "telephone_number": "423-697-2000",
            "fax_number": "423-697-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 DESALES AVE STE F1009",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041161",
            "telephone_number": "423-697-2000",
            "fax_number": "423-697-2320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Sivley Rd SW Ste 500",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358015177",
            "country_code": "US",
            "telephone_number": "256-265-3880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "HALEY",
        "middle_name": "NEVELS",
        "name_prefix": "Ms.",
        "credential": "AGACNP-BC, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-18",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-127930",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-127930",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "34000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALEY",
            "last_name": "NEVELS",
            "middle_name": "BROOKE",
            "prefix": "MRS.",
            "credential": "AGACNP-BC, FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.