Individual provider Active NPI

Michelle Lynn Wilson, FNP

  • Family Nurse Practitioner
  • Boonville, IN
National Provider Identifier
1982053385
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71006477A Issued in IN
Practice address
899 Aigner Dr
Boonville, IN 47601-8473
Phone
(812) 641-0262
Fax
(812) 641-0557
NPI assigned
Jun 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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 71006477A IN Primary

Addresses

Primary practice location

899 Aigner Dr
Boonville, IN 47601-8473

Mailing address

899 Aigner Dr
Boonville, IN 47601-8473
Phone (812) 641-0262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20160909000811 IN Practitioner - Nurse Practitioner 7012203516 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wilson Family Practice, LLCGroup PAC ID 5092055491, 4 clinicians

Practice addresses (Care Compare)

899 Aigner Dr
Boonville, IN 47601-8473
Phone (812) 641-0262

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Evansville, IN, CCN 157529
  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082
  • The Women'S Hospital Hospital, Newburgh, IN, CCN 150149
  • Ascension St Vincent Warrick Hospital, Boonville, IN, CCN 151325

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71006477AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Evansville Multi-Specialty Clinic, PC Family CurrentSince Jul 10, 2017 Accepting new patients
Evansville Cancer Care, PC CurrentSince Jul 10, 2017 Accepting new patients

Locations

6140 E Columbia St
Evansville, IN 47715
Phone (812) 474-1110

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1982053385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "899 AIGNER DR",
            "city": "BOONVILLE",
            "state": "IN",
            "postal_code": "476018473",
            "telephone_number": "812-641-0262",
            "fax_number": "812-641-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 AIGNER DR",
            "city": "BOONVILLE",
            "state": "IN",
            "postal_code": "476018473",
            "telephone_number": "812-641-0262",
            "fax_number": "812-641-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006477A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boonville, IN

Sources for this page

Verify at the official NPI Registry.