Jessica Lynn Wilson, CNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

8121 Issued in MN

Practice address

10 4TH Ave SE
Glenwood, MN 56334-1820

Phone

(320) 634-4521

Fax

(320) 634-2253

NPI assigned

Apr 5, 2021

Last updated

Apr 5, 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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 Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/glac-1755385c

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.

• Glacial Ridge Hospital District

  dba Brooten Medical Center

  • Family Medicine Physician
  • Brooten, MN
  • NPI 1255348223
  Medicare reassignment NPD
• Glacial Ridge Hospital District

  • Critical Access Hospital
  • Glenwood, MN
  • NPI 1538178520
  Medicare reassignment NPD
• Glacial Ridge Hospital District

  dba Starbuck Medical Center

  • Rural Health Clinic/Center
  • Starbuck, MN
  • NPI 1063952026
  NPD

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1942889209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 4TH AVE SE",
            "city": "GLENWOOD",
            "state": "MN",
            "postal_code": "563341820",
            "telephone_number": "320-634-4521",
            "fax_number": "320-634-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 4TH AVE SE",
            "city": "GLENWOOD",
            "state": "MN",
            "postal_code": "563341820",
            "telephone_number": "320-634-4521",
            "fax_number": "320-634-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MN",
            "license": "8121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikki Wait
• Tayler Waldvogel, M.S. LADC, LPCC
• Carl Stephen Wallin, D.D.S.
• Western Prairie Human Services
• Luke Thomas Wilmes, RN
• Kemma Wing, LPCC
• Kristi Mae Winter, APRN CNP
• Suzanne Winter, PHARMD
• Wayne Edwin Zimmerman, MSLP

• Primary Care Nurse Practitioner in Glenwood, MN
• Providers in Glenwood, MN by specialty
• Primary Care Nurse Practitioner in Minnesota

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

Verify at the official NPI Registry.