Active NPI
Jamie C Wilson, RN
- Registered Nurse
- Phoenix, AZ
National Provider Identifier
1962052746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 204633
- Practice address
- 4212 N 16TH St
Phoenix, AZ 85016-5319 - Phone
- (602) 263-1200
- NPI assigned
- Sep 13, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | 204633 | AZ | |
| Ambulatory Women's Health Care Registered Nurse | 163WW0101X | 204633 | AZ | |
| Registered Nurse | 163W00000X | 204633 | AZ | Primary |
Addresses
Primary practice location
4212 N 16TH St
Phoenix, AZ 85016-5319
Mailing address
PO Box 45538
Phoenix, AZ 85064-5538
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 204633 | AZ | MD | Ambulatory Women's Health Care Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568332800000",
"number": "1962052746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 45538",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850645538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4212 N 16TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850165319",
"telephone_number": "602-263-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JAMIE",
"middle_name": "C",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-13",
"last_updated": "2019-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": "AZ",
"license": "204633",
"primary": false
},
{
"code": "163WW0101X",
"taxonomy_group": "",
"desc": "Registered Nurse, Women's Health Care, Ambulatory",
"state": "AZ",
"license": "204633",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AZ",
"license": "204633",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.