Jessica Wilson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1047 Issued in KY

Practice address

1025 Grand Avenue
Beattyville, KY 41311

Phone

(606) 464-2401

Fax

(606) 464-3290

NPI assigned

Sep 18, 2007

Last updated

May 19, 2022By 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

Other identifiers 1

Other names 1

• Jessica Botner Former name

Medicare fee-for-service enrollment

Enrolled in KY

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

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Juniper Health IncGroup PAC ID 2961453618, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kentucky River District HHA Home health agency, Beattyville, KY, CCN 187050
• Marcum and Wallace Memorial Hospital Hospital, Irvine, KY, CCN 181301
• Baptist Health Richmond Hospital, Richmond, KY, CCN 180049
• Baptist Health Lexington Hospital, Lexington, KY, CCN 180103

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jessica.wilson.p1@direct.juniperhealth.nextgenshare.com
• Direct secure messaging: jessicawilson@juniperhea.allscriptsdirect.net

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.

• Juniper Health Inc

  dba Lee County Family Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Beattyville, KY
  • NPI 1407818628
  Medicare reassignment Care Compare group NPD (past)
• Juniper Health Inc

  dba Juniper Health Campton Elementary School

  • Federally Qualified Health Center (FQHC)
  • Campton, KY
  • NPI 1922886589
  NPD
• QPS LLC

  dba Elliott Pharmacy

  • Community/Retail Pharmacy
  • Sandy Hook, KY
  • NPI 1538901186
  NPD

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

• Baptist Healthcare System, Inc

  dba Baptist Health Lexington

  • General Acute Care Hospital
  • Lexington, KY
  • NPI 1538244918
  Care Compare affiliation
• Baptist Healthcare System, Inc.

  dba Baptist Health

  • General Acute Care Hospital
  • Richmond, KY
  • NPI 1568452290
  Care Compare affiliation
• Kentucky River District Health Department

  • Home Health Agency
  • Hazard, KY
  • NPI 1922182815
  Care Compare affiliation
• Mercy Health-Marcum & Wallace Hospital LLC

  dba Mercy Health Marcum and Wallace Hospital

  • Critical Access Hospital
  • Irvine, KY
  • NPI 1487643821
  Care Compare affiliation

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1952597585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 690",
            "city": "BEATTYVILLE",
            "state": "KY",
            "postal_code": "413110690",
            "telephone_number": "606-464-0151",
            "fax_number": "606-464-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 GRAND AVENUE",
            "city": "BEATTYVILLE",
            "state": "KY",
            "postal_code": "41311",
            "telephone_number": "606-464-2401",
            "fax_number": "606-464-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100021290",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BOTNER",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• The Geri-Young House, Inc.
• United Clinics of Kentucky LLC
• Walgreen Co (Walgreens #18427)
• Kellie D Watts, LCSW
• Denise Whitcher, M.D.
• Misty Kristina Woods-Bolton

• Physician Assistant in Beattyville, KY
• Providers in Beattyville, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.
• 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.