KIM DITTIS WILSON (NPI# 1134169311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134169311 |
| Entity Type | Individual |
| Full Name | KIM DITTIS WILSON |
| Credential | NP |
| Practice Address |
900 E Michigan Ave Ste 105 Jackson MI 49201-2490 |
| Mailing Address |
900 E Michigan Ave Ste 105 Jackson MI 49201-2490 |
| Practice Telephone | 5177823190 |
| Practice Fax Number | 5177821223 |
| Mailing Telephone | 5177823190 |
| Mailing Fax Number | 5177821223 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 4704131316 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | RR MEIDCARE | 500017755 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 205 N East Ave, Jackson, MI 492011753 | 5177884750 | 5177895968 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245725365 | Kim Marie Wilson | Registered Nurse | 211 201st Ave Ne, Snohomish, WA 98290-9613 | 2018-06-30 |
| 1639583669 | Kim Wilson | Home Health | 136 Field Pine Ave, Hopkins, SC 29061-9501 | 2014-06-18 |
| 1073532438 | Kim Yvette Wilson | Pharmacist | 3800 Fletcher Ave, Suite 133, Tampa, FL 33613 | 2006-07-18 |
| 1033584966 | Kim Wilson | Counselor | 25 Gap Rd, Batesville, AR 72501-8679 | 2015-12-03 |
| 1073982245 | Kim Wilson | Physician Assistant | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2015-09-17 |
| 1134398126 | Kim Yung Wilson | Occupational Therapist | 14701 Cecil Dr, Little Rock, AR 72223-1913 | 2008-02-25 |
| 1639383474 | Kim Marie Wilson | Nurse Practitioner | 3400 Spruce St, 4 Dulles Building, Philadelphia, PA 19104-4206 | 2007-05-10 |
| 1821215781 | Kim Badell Wilson | Dentist | 288 Northwood Ave, Jasper, IN 47546-1212 | 2007-04-19 |
| 1124194006 | Kim A Wilson | Pediatrics | 75 Bickford St, Martha Eliot Health Center, Jamaica Plain, MA 02130-1401 | 2006-11-24 |
| 1457468928 | Kim Wilson | Radiology | 3601 S 6th Ave, Tucson, AZ 85723-0001 | 2006-08-23 |
| Street Address |
900 E MICHIGAN AVE STE 105 |
| City | JACKSON |
| State | MI |
| Zip Code | 49201-2490 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235348400 | Anish Wadhwa | Internal Medicine | 900 E Michigan Ave Ste 105, Jackson, MI 49201-2490 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174137863 | Sally Ann Shaw | Behavior Technician | 3699 Miles Rd., Jackson, MI 49201 | 2020-09-01 |
| 1780293043 | Alyn Kristin Kay | Technician | Hope Network-hope's Door Cru, 3699 Miles Rd., Jackson, MI 49201 | 2020-07-23 |
| 1841827946 | Maverick Jubane | Student in an Organized Health Care Education/Training Program | Henry Ford Allegiance Health, 205 N East Avenue, Jackson, MI 49201 | 2020-03-26 |
| 1306486584 | Cody Williams | Technician, Other | 1001 Laurence Avenue St E, Jackson, MI 49201 | 2020-01-15 |
| 1720632292 | Krystie Lynn Adorjan | Speech-Language Pathologist | 1175 W Parnall Rd, Jackson, MI 49201 | 2019-08-01 |
| 1407412653 | Howard Franklin Tanner II | Speech-Language Pathologist | 102 East Michigan Avenue, Jackson, MI 49201 | 2019-05-14 |
| 1356863740 | Rima Zarar Qayyum | Speech-Language Pathologist | 4800 Firethorn Dr., Jackson, MI 49201 | 2017-07-07 |
| 1306384383 | Briana Nesmith | Speech-Language Pathologist | 2025 Ann Arbor Road, Jackson, MI 49201 | 2017-02-09 |
| 1255878062 | W.a. Foote Memorial Hospital, Inc | Otolaryngology | 205 N.east Ave, Jackson, MI 49201 | 2017-01-31 |
| 1306212881 | Aisha Henderson | Social Worker | 729 West Michigan Avenue, Jackson, MI 49201 | 2015-08-19 |
| Find all providers in zip 49201 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093332546 | Jaleesa Atkins | Nurse Practitioner | 4266 Springbrook Rd, Jackson, MI 49201-9716 | 2020-07-01 |
| 1457983785 | Amos N Macharia | Nurse Practitioner | 2130 Ridge Rd, Jackson, MO 63755-1612 | 2020-02-05 |
| 1649819590 | George Cavett Jr. | Nurse Practitioner | 2450 Twisted Oak Dr, Jackson, MS 39212-2137 | 2019-12-24 |
| 1851934723 | Hannah Louise Keel | Nurse Practitioner | 623 Gettysburg Dr, Jackson, TN 38305-7886 | 2019-10-23 |
| 1013559186 | Kirsten Siler | Nurse Practitioner | 27a Medical Center Drive, Jackson, TN 38301-3949 | 2019-10-10 |
| 1801447693 | Milestone Primary Care House Calls, LLC | Nurse Practitioner | 5260 Cedar Park Dr Ste E, Jackson, MS 39206-4131 | 2019-09-24 |
| 1750855870 | Michael L Chesney | Nurse Practitioner | 6055 Jordan Rd, Jackson, MI 49201-9580 | 2019-01-12 |
| 1609356500 | Angela Sophia Mcreynolds | Nurse Practitioner | 2500 N State St Rm S347, Jackson, MS 39216-4500 | 2018-08-20 |
| 1679050132 | Alicia Faye Green | Nurse Practitioner | 908 Bella Vista Dr, Jackson, MO 63755-7863 | 2018-07-26 |
| 1982119228 | Felix Taylor | Nurse Practitioner | 514 E Woodrow Wilson Ave Ste B, Jackson, MS 39216-4538 | 2017-12-08 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.