Gary Mark Wilson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A004043 Issued in AR

Practice address

4901 E Johnson Ave
Jonesboro, AR 72405-8417

Phone

(870) 936-8000

Fax

(870) 934-3659

NPI assigned

Jul 24, 2013

Sex

Male

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 AR

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

Nurse Practitioner

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Red River Health LLCGroup PAC ID 7416320783, 6 clinicians

Northeast Arkansas Clinic Charitable Foundation, Inc.Group PAC ID 2961547526, 294 clinicians

East Arkansas Emergency Physicians PLLCGroup PAC ID 5698909067, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Memorial Hospital Jonesboro, Inc. Hospital, Jonesboro, AR, CCN 040118

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• East Arkansas Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Blytheville, AR
  • NPI 1932442985

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Northeast Arkansas Clinic Charitable Foundation, Inc.

  • Multi-Specialty Clinic/Center
  • Jonesboro, AR
  • NPI 1861721839
  Medicare reassignment Care Compare group NPD
• Red River Health, LLC

  • Multi-Specialty Clinic/Center
  • Jonesboro, AR
  • NPI 1346923273

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• East Arkansas Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Osceola, AR
  • NPI 1043553860

  Nurse Practitioner

  NPD
• East Arkansas Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Clarksville, AR
  • NPI 1609259753

  Nurse Practitioner

  NPD
• Northeast Arkansas Clinic Charitable Foundation, Inc.

  • Mobile Mammography Clinic/Center
  • Jonesboro, AR
  • NPI 1417721689
  NPD
• Northeast Arkansas Clinic Charitable Foundation, Inc.

  • Clinical Medical Laboratory
  • Jonesboro, AR
  • NPI 1801127030
  NPD
• Northeast Arkansas Clinic Charitable Foundation, Inc.

  • Anesthesiology Physician
  • Jonesboro, AR
  • NPI 1992036032
  NPD (past)
• Red River Health, LLC

  • Multi-Specialty Clinic/Center
  • Texarkana, TX
  • NPI 1205552130

  Nurse Practitioner

  NPD (past)

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

• Baptist Memorial Hospital-Jonesboro Inc

  • General Acute Care Hospital
  • Jonesboro, AR
  • NPI 1386699353
  Care Compare affiliation

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1962844522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1960",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724031960",
            "telephone_number": "870-936-8000",
            "fax_number": "870-934-3659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 E JOHNSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724058417",
            "telephone_number": "870-936-8000",
            "fax_number": "870-934-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "GARY",
        "middle_name": "MARK",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-24",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2013026042",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cade Malone Wilson, O.D.
• Chasyl Wilson
• Christie M Wilson, SLP
• Cynthia Wilson
• Erik A. Wilson, LPC
• George Marc Wilson, LCSW
• Gregory Wilson
• Hannah Wilson
• Hayleigh Wilson
• Jeremy Daniel Wilson, MHPP

• Family Nurse Practitioner in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.