Nichole Wilson, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

F308344 Issued in NY

Practice address

355 Prairie Ave
Providence, RI 02905-1928

Phone

(401) 444-0570

Fax

(401) 444-0427

NPI assigned

Jun 2, 2018

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 NY, RI2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Providence Community Health Centers Inc.Group PAC ID 9335050962, 90 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HHFGDD

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.

• The Providence Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Providence, RI
  • NPI 1053313593
  Medicare reassignment Care Compare group NPD
• Cross Island Medical LLC

  • Internal Medicine Physician
  • Howard Beach, NY
  • NPI 1285290775
  Medicare reassignment NPD
• Rockwell Health LLC

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1699479733
  Medicare reassignment NPD
• The Providence Community Health Centers Inc.

  • Federally Qualified Health Center (FQHC)
  • Providence, RI
  • NPI 1558650986
  NPD (past)
• Ilyagu Medical PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1730859935
  NPD (past)

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

{
    "created_epoch": "1527897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1881186120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ALLENS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055010",
            "telephone_number": "401-444-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 PRAIRIE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029051928",
            "telephone_number": "401-444-0570",
            "fax_number": "401-444-0427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7404 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112092704",
            "country_code": "US",
            "telephone_number": "401-536-3106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "NICHOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-02",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "RI",
            "license": "APRN03871",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F308344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connor Keith Wilson, MD, MPH
• Corinna Wilson, LMT
• Ira B. Wilson, MD
• Jadine Sandra Wilson, M.ED, BCBA, LBA
• Maurina Wilson, LCDP, LADC, CADC
• Taneisha Wilson, M.D.
• Janet L Wilterdink, MD
• Sara Wilton, LMHC-A
• Revathi Wims
• Suzy Barcelos Winchester, MSW, LCSW

• Primary Care Nurse Practitioner in Providence, RI
• Providers in Providence, RI by specialty
• Primary Care Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.