Jackilyn Wilson, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

019508 Issued in OH

Practice address

3120 Governors Place Blvd
Dayton, OH 45409-1328

Phone

(937) 293-1622

Fax

(937) 245-6308

NPI assigned

Jul 25, 2016

Last updated

Nov 11, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Wright State University Boonshoft School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

Merit-based Incentive Payment System (MIPS)

Final score

81.38 of 100Reported as group

Quality

66.25

Promoting interoperability

100

Improvement activities

40

Cost

71.69

Merit-based Incentive Payment System (MIPS)

Final score

87.23 of 100Reported as group

Quality

83.64

Promoting interoperability

100

Improvement activities

40

Cost

73.78

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Premier Health Specialists Inc

  • Internal Medicine Physician
  • Moraine, OH
  • NPI 1194958223
  Medicare reassignment Care Compare group NPD
• Dayton Lung and Sleep Medicine Inc

  • Pulmonary Disease Physician
  • Englewood, OH
  • NPI 1982621751
  Medicare reassignment NPD
• Hisey Physician Services, LLC

  • Hospitalist Physician
  • Middletown, OH
  • NPI 1073380614
  Medicare reassignment NPD
• Mvhe Inc

  • Family Medicine Physician
  • Moraine, OH
  • NPI 1659504785
  Medicare reassignment NPD
• Sinclair Physician Services, LLC

  • Hospitalist Physician
  • Dayton, OH
  • NPI 1063289601
  Medicare reassignment NPD
• Upper Valley Professional Corporation

  • Family Medicine Physician
  • Troy, OH
  • NPI 1407872518
  Medicare reassignment NPD
• Mvhe Inc

  dba Miami Valley Hospitalist Group

  • Hospitalist Physician
  • Dayton, OH
  • NPI 1356394795
  NPD
• Mvhe Inc

  dba Middletown Medical Group

  • Internal Medicine Physician
  • Middletown, OH
  • NPI 1497154827
  NPD
• Premier Health Specialists Inc

  dba Advanced Ankle and Foot Specialists

  • Foot & Ankle Surgery Podiatrist
  • Dayton, OH
  • NPI 1902211287
  NPD
• Premier Heart Associates, Inc

  • Cardiovascular Disease Physician
  • Beavercreek, OH
  • NPI 1538188735
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Miami Valley Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1073688354
  Care Compare affiliation

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1811440092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SUGAR CAMP CIR",
            "address_2": "STE 200",
            "city": "OAKWOOD",
            "state": "OH",
            "postal_code": "454091981",
            "telephone_number": "937-276-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 GOVERNORS PLACE BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454091328",
            "telephone_number": "937-293-1622",
            "fax_number": "937-245-6308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3120 Governors Place Blvd",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454091328",
            "country_code": "US",
            "telephone_number": "937-293-1622",
            "fax_number": "937-245-6308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JACKILYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-25",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "019508",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "RN328660",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Elizabeth Wilson, LPN
• Darby Wilson, LSW
• Deanna Wilson
• Emma Mae Wilson, RD
• Heather Wilson
• Jason Luke Wilson
• Jennifer Wilson, CCC-SLP
• Julienne Elizabeth Wilson, MIDWIFE
• Kacey L Wilson
• Kristie Jean Wilson

• Acute Care Nurse Practitioner in Dayton, OH
• Providers in Dayton, OH by specialty
• Acute Care Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.
• 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.