ABBY JAN WILSON FNP-BC, RD, CDCES
NPI 1033544580
Nurse Practitioner - Family in Blackfoot, ID
About Abby Jan Wilson Fnp-bc, Rd, Cdces NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ABBY JAN WILSON FNP-BC, RD, CDCES (NPI 1033544580) is an individual family provider in Blackfoot, Idaho, licensed in Idaho (3771381) and active in the NPI registry since September 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Abby Jan Wilson Fnp-bc, Rd, Cdces is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 83221 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BLACKFOOT, ID 83221
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Abby Wilson's NPI number?
The NPI number for Abby Wilson is 1033544580. It was assigned to this individual provider in the NPPES registry on September 3, 2013. The provider is also known as Abby Jan Gustaveson Fnp-Cnp, Rn, Rd, Ld.
Where is Abby Wilson located?
Abby Wilson practices at 98 Poplar St, Blackfoot, ID 83221. The listed phone number is (208) 785-4100.
What is Abby Wilson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Abby Wilson enrolled in Medicare?
Yes. Abby Wilson is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Abby Wilson was last updated on August 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Abby Jan Wilson, FNP-BC, RD, CDCES · NPI 1033544580
Family physician in Blackfoot, Idaho. Individual provider, active in the CMS NPPES registry since September 3, 2013.
## Identity
- **NPI:** 1033544580 (Entity type: Individual)
- **Enumerated:** September 3, 2013
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 3771381 (Idaho)
- **Sole proprietor:** No
## Practice location
- **Address:** 98 POPLAR ST, Blackfoot, ID 83221-1758
- **Phone:** (208) 785-4100
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** August 11, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1033544580) · Data from the CMS NPPES public registry.