KENYATTA NICOLE WILSON NP-C
NPI 1457633034
Nurse Practitioner - Family in Vicksburg, MS

Q: What is Kenyatta Wilson's NPI number?

The NPI number for Kenyatta Wilson is 1457633034. It was assigned to this individual provider in the NPPES registry on September 9, 2011. The provider is also known as Kenyatta N Moore Np-C.

Q: What is Kenyatta Wilson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Kenyatta Wilson was last updated on May 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.

Active since September 09, 2011PECOS EnrolledAccepts Medicare Assignment

89.76/100

CMS Quality Rating

2200 HIGHWAY 61 N, VICKSBURG, MS 39183(601) 883-3340 Get Directions Write a Review

NPPES record last updated: May 29, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 29, 2023, Nov 17, 2022, Oct 10, 2022 (3 updates tracked since 2022).

On this page

About Kenyatta Nicole Wilson Np-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENYATTA NICOLE WILSON NP-C (NPI 1457633034) is an individual family provider in Vicksburg, Mississippi, licensed in Mississippi (R871546) and active in the NPI registry since September 2011. She is enrolled in Medicare PECOS, is affiliated with Merit Health River Region, and maintains a secondary practice location in Clinton.

NPPES Registry Identity

NPI1457633034

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKENYATTA NICOLE WILSONCredential: NP-C

Location Address2200 HIGHWAY 61 NVicksburg, MS 39183-8246

Mailing Address2200 Highway 61 NVicksburg, MS 39183-8246 · (601) 529-1445

Phone(601) 883-3340

Sole ProprietorNo

Medical School CMSOtherGraduated 2011

Enumeration DateSeptember 9, 2011

Last NPPES UpdateMay 29, 20233 updates tracked since enumeration

NPPES CertifiedMay 29, 2023

✔ NPI 1457633034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MS · R871546

2200 HIGHWAY 61 N, Vicksburg, MS 39183

Open in Google Maps ↗

Other Names 1

Other Name (5)Kenyatta N Moore Np-c

Secondary Practice Location 1

Location 1106 Clinton PkwyClinton, MS 39056-4730 · Phone (601) 924-9005 · Fax (601) 973-1622

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kenyatta Nicole Wilson Np-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5799943106

PECOS Enrollment IDI20120214000728, I20180808000059

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

175 services146 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

24 services22 patients

Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19) and influenza virus types a and b 87636

This test detects the presence of SARS-CoV-2 (COVID-19) and Influenza types A and B in your body. It uses a method called the multiplex amplified probe technique to amplify and identify specific virus genes. It helps in early diagnosis and appropriate treatment.

22 services22 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

21 services20 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

19 services19 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Merit Health River Region

Acute Care Hospitals · Vicksburg, MS

2/5 CMS rating

OwnershipProprietary

CMS Certification Number250031

Location2100 Hwy 61 NVicksburg, MS 39183 · Warren County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39183 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

89.76/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

75.59

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LA MISS DIABETIC SHOES

Durable Medical Equipment & Medical Supplies

2200 HIGHWAY 61 N, SUITE 3400
VICKSBURG, MS 39183

Warren County (601) 883-3342

MRS. CARRIE EURE PA-C

Physician Assistant