Jolie Lee Wilson, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1-155609 Issued in AL

Practice address

1449 Temple Rd
Bremen, GA 30110-2378

Phone

(770) 537-2367

Fax

(770) 537-1203

NPI assigned

May 26, 2015

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 AL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Registered Nurse

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 and National Provider Directory roles.

• Grayson and Associates PC

  • Psychiatry Physician
  • Birmingham, AL
  • NPI 1194772442
  Medicare reassignment NPD
• SVPS Psychiatric Services LLC

  • Psychiatry Physician
  • Birmingham, AL
  • NPI 1447528591
  NPD (past)

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1831578749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1449 TEMPLE RD",
            "city": "BREMEN",
            "state": "GA",
            "postal_code": "301102378",
            "telephone_number": "770-537-2367",
            "fax_number": "770-537-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1449 TEMPLE RD",
            "city": "BREMEN",
            "state": "GA",
            "postal_code": "301102378",
            "telephone_number": "770-537-2367",
            "fax_number": "770-537-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JOLIE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-26",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN220869",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-155609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayleigh Warren, LMT
• Kimberly Ann Wilkerson, LDO
• Amanda Musick Williams, FNP-C
• Harry Boyd Williams Jr., D.D.S.
• Tina Marie Williams, CPRP
• Tiffany L Wynter

• Psychiatric/Mental Health Nurse Practitioner in Bremen, GA
• Providers in Bremen, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.