Tammy Lynn Wilson, AGACNP is a medicare enrolled "Family Medicine - Adult Medicine" in Laceys Spring, Alabama. Her current practice location is
4258 Highway 231 Ste 5, Laceys Spring, Alabama. You can reach out to her office (for appointments etc.) via phone at
(256) 498-6500.
Tammy Lynn Wilson is licensed to practice in Alabama (license number 1-127155) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1235703240.
Provider's Profile
| Full Name | Tammy Lynn Wilson |
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| Gender | Female |
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| Speciality | Family Medicine - Adult Medicine |
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| Location | 4258 Highway 231 Ste 5, Laceys Spring, Alabama |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1235703240
- Provider Enumeration Date: 05/14/2021
- Last Update Date: 10/12/2022
Medicare PECOS Information:
- PECOS PAC ID: 6305234485
- Enrollment ID: I20211021002199
Medical Identifiers
Medical identifiers for Tammy Lynn Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1235703240 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LA2100X | Nurse Practitioner - Acute Care | 1-127155 (Alabama) | Secondary |
| 363LA2100X | Nurse Practitioner - Acute Care | 13227637 (Alabama) | Secondary |
| 207QA0505X | Family Medicine - Adult Medicine | 1-127155 (Alabama) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Tammy Lynn Wilson allows following entities to bill medicare on her behalf.
| Entity Name | Valley Sunrise Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1215699160
PECOS PAC ID: 8628466794
Enrollment ID: O20211021001601 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tammy Lynn Wilson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Tammy Lynn Wilson, AGACNP
4258 Highway 231 Ste 5,
Laceys Spring, AL 35754-6444
Ph: (256) 498-6500 | Tammy Lynn Wilson, AGACNP
4258 Highway 231 Ste 5,
Laceys Spring, AL 35754-6444
Ph: (256) 498-6500 |
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