Individual provider Active NPI

Dannylu J Wilson, NP

  • Family Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1972673648
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5510 Issued in TN
Practice address
435 Airport Blvd
Pensacola, FL 32503-7847
Phone
(850) 435-7448
Fax
(850) 435-3156
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5510 TN Primary

Addresses

Primary practice location

435 Airport Blvd
Pensacola, FL 32503-7847

Mailing address

435 Airport Blvd
Pensacola, FL 32503-7847
Phone (850) 435-7448

Other identifiers 6

IdentifierTypeStateIssuer
1507471MedicaidTN
3732438MedicaidTN
4135398OtherTNBCBST
4193459OtherBCBS
3346726MedicaidTN
3710089MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20040417000604 TN Practitioner - Certified Clinical Nurse Specialist (CNS) 4486649563 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5510TNMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Thomas Hickman Hospital CurrentSince Oct 12, 2015 Accepting new patients
Saint Thomas Medical Partners CurrentSince Nov 3, 2015 Accepting new patients
Hickman Community Health Careservices CurrentSince Oct 12, 2015 Accepting new patients
Maury Regional Hospital Current Accepting new patients
Sleep Service S PLLC PastSince Jan 15, 2019 Accepting new patients
Maury Regional Ambulatory Care Center Inc. Family Past Accepting new patients

Locations

150 E Swan St
Centerville, TN 37033
Phone (931) 729-3091

854 W James M Campbell Blvd
Ste 303
Columbia, TN 38401
Phone (931) 388-8779

854 W James M Campbell Blvd
Ste 303B
Columbia, TN 38401

1224 Trotwood Ave
Columbia, TN 38401
Phone (931) 380-4072

617 W Main St
Hohenwald, TN 38462
Phone (931) 796-4901

300 20th Ave N
Fl 9
Nashville, TN 37203

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1972673648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 AIRPORT BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325037847",
            "telephone_number": "850-435-7448",
            "fax_number": "850-435-3156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 AIRPORT BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325037847",
            "telephone_number": "850-435-7448",
            "fax_number": "850-435-3156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DANNYLU",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "5510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1507471",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3732438",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "4135398",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4193459",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3346726",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3710089",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.