Bethany Ray Wilson, APSS

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

KCCHW12307238 Issued in KY

Practice address

333 Waller Ave Ste 250
Lexington, KY 40504-2915

Phone

(859) 562-1770

NPI assigned

Feb 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Bethany Ray Ruckel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1790286532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3677 BEATEN PATH",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405098564",
            "telephone_number": "859-209-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 WALLER AVE STE 250",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042915",
            "telephone_number": "859-562-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BETHANY",
        "middle_name": "RAY",
        "credential": "APSS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-27",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "KY",
            "license": "1164221",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "KY",
            "license": "KCCHW12307238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790731081",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "RUCKEL",
            "middle_name": "RAY",
            "credential": "AS, CCHW, TCM, APSS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexandra Wilson, RN
• Alexandria Lauren Wilson, PA
• Andrew Stuart Wilson, MD
• Annie Wilson, PA-C
• Benjamin Ray Wilson, M.D.
• Brandi Leshay Wilson, RN
• Dana E Wilson, ST
• Debra G Wilson, LPCC
• Denise Wilson, RBT
• Derek Wilson, MD

• Community Health Worker in Lexington, KY
• Providers in Lexington, KY by specialty
• Community Health Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.