Jessica Wilson, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

962666 Issued in CA

Practice address

2650 Suzanne Way Ste 200
Eugene, OR 97408-7619

Phone

(541) 228-3020

NPI assigned

Mar 22, 2007

Sex

Female

Sole proprietor

Yes

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 CA

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lyon-Martin Community Health ServicesGroup PAC ID 6103203930, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lyon-Martin Community Health Services

  • Community Health Clinic/Center
  • San Francisco, CA
  • NPI 1588238497
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396915200000",
    "number": "1992822316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 W 12TH AVE APT 227",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974024087",
            "telephone_number": "541-228-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 SUZANNE WAY STE 200",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974087619",
            "telephone_number": "541-228-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2014-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "962666",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "962666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Renee Wilson
• Brenda Lynn Wilson, LMT
• Elizabeth Amy Wilson, ATC
• Erica Wilson, MS, QMHP, LPC
• Jennifer Susan Wilson, RN
• John Wells Wilson, MD
• Kiana B Wilson
• Kimberly Louise Wilson
• Kirk F Wilson, FRA
• Kristin Kathleen Wilson, RN

• Registered Dietitian in Eugene, OR
• Providers in Eugene, OR by specialty
• Registered Dietitian in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.