Individual provider Active NPI

Marcie Lynne Wilson, ARNP

  • Nurse Practitioner
  • Des Moines, IA
National Provider Identifier
1801196340
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
L107756 Issued in IA
Practice address
1111 6TH Ave Ste B1
Des Moines, IA 50314-2610
Phone
(515) 358-0100
Fax
(515) 358-0109
NPI assigned
Nov 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X L-107756 IA
Nurse Practitioner 363L00000X L107756 IA Primary

Addresses

Primary practice location

1111 6TH Ave Ste B1
Des Moines, IA 50314-2610

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 358-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20110311000437 IA Practitioner - Nurse Practitioner 5890977854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

1111 6TH Ave
Des Moines, IA 50314-2613
Phone (515) 247-4240

330 Laurel St
Suite 1200
Des Moines, IA 50314-3044
Phone (515) 643-6290

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107756IAMDMarriage & Family Therapist
L-107756IAMDNurse Practitioner
L107756IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc. Nurse Practitioner CurrentSince Jan 1, 2019 Accepting new patients
Mercy Clinics, Inc. Current Accepting new patients
Boone County Hospital Past Accepting new patients

Locations

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

411 Laurel St
Ste A120
Des Moines, IA 50314
Phone (515) 247-3970

1111 6th Ave
Ste B1
Des Moines, IA 50314
Phone (515) 358-0100

1111 6th Ave
Des Moines, IA 50314
Phone (515) 247-3121

1601 NW 114th St
Ste 347
Des Moines, IA 50325
Phone (515) 222-7350

Interoperability endpoints

  • Direct secure messaging: mwilson3961260@direct.trinity-health.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 5

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": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1801196340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-358-0100",
            "fax_number": "515-358-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 6TH AVE STE B1",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142610",
            "telephone_number": "515-358-0100",
            "fax_number": "515-358-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARCIE",
        "middle_name": "LYNNE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-01",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "L-107756",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "L107756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.