Individual provider Active NPI

Jennifer Daye Wilson, FNP

  • Registered Nurse
  • Las Vegas, NV
National Provider Identifier
1902784317
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
5483944-3102 Issued in UT
Practice address
5112 Brookmere Dr
Las Vegas, NV 89130-5220
Phone
(801) 792-6033
NPI assigned
Aug 25, 2025
Last updated
Aug 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 5483944-3102 UT Primary

Addresses

Primary practice location

5112 Brookmere Dr
Las Vegas, NV 89130-5220

Mailing address

5112 Brookmere Dr
Las Vegas, NV 89130-5220
Phone (801) 792-6033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20260108001916 NV Practitioner - Nurse Practitioner 6204312309 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Toetal Health Solutions NV PCGroup PAC ID 9234625393, 7 clinicians
Toe-Tal Family FootcareGroup PAC ID 2668868761, 7 clinicians

Practice addresses (Care Compare)

Las Vegas, NV 89145
Phone (702) 271-6327

3317 Salmon Creek Dr
Las Vegas, NV 89129-6188
Phone (702) 956-3750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5483944-3102UTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Blackbird Care Current Accepting new patients
Integrity Medical and Wounds LLC CurrentSince Oct 1, 2025 Accepting new patients
Toe-Tal Family Footcare CurrentSince Oct 23, 2025 Accepting new patients
Toetal Health Solutions NV PC CurrentSince Oct 23, 2025 Accepting new patients
Toe-Tal Family Footcare Associates PastSince Oct 23, 2025 Accepting new patients

Locations

2604 El Camino Real
Ste 311
Carlsbad, CA 92008

222 S Rainbow Blvd
Ste 114
Las Vegas, NV 89145
Phone (702) 271-6327

801 S Rancho Dr
Ste B2
Las Vegas, NV 89106
Phone (702) 331-4808

Interoperability endpoints

  • FHIR API: https://drchrono-fhirpresentation.everhealthsoftware.com/fhir/drchrono/509568/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/HJBBED/Endpoint/HJBBED

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1756080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1902784317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5112 BROOKMERE DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891305220",
            "telephone_number": "801-792-6033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5112 BROOKMERE DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891305220",
            "telephone_number": "801-792-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JENNIFER",
        "middle_name": "DAYE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-25",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "5483944-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.