Clio Health Clinic LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

CLIO HEALTH CLINIC LLC

Practice address

1203 Blue Springs St
Clio, AL 36017-2523

Phone

(334) 490-1200

Fax

(334) 780-1070

NPI assigned

Nov 3, 2022

Last updated

Dec 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ursula S Wilson, LNPNPI 1518116581

Title

Ceo

Phone

(334) 490-1200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ursula S Wilson, FNP

  • Family Nurse Practitioner
  • Clio, AL
  • NPI 1518116581
  Medicare reassignment NPD Authorized official
• Thomas William Brown, M.D.

  • Hematology & Oncology Physician
  • Troy, AL
  • NPI 1609976612
  Medicare reassignment NPD

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703635200000",
    "number": "1801503297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 BLUE SPRINGS ST",
            "city": "CLIO",
            "state": "AL",
            "postal_code": "360172523",
            "telephone_number": "334-490-1200",
            "fax_number": "334-780-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 BLUE SPRINGS ST",
            "city": "CLIO",
            "state": "AL",
            "postal_code": "360172523",
            "telephone_number": "334-490-1200",
            "fax_number": "334-780-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIO HEALTH CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-03",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "URSULA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "334-490-1200",
        "authorized_official_credential": "LNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ambrea Anthony, NP
• Clio Rescue Squad Inc
• Gerald Lamar Jowers, RPH
• Charlene D McMullin, NP
• Pratts Station LLC (Clio Drug Co)
• Ursula S Wilson, FNP

• Nurse Practitioner in Clio, AL
• Providers in Clio, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.