LORETTA SUE WILSON (N.P) – Nurse Practitioner, NPI 1407002603

LORETTA SUE WILSON (N.P) is a healthcare provider. based in Gray, Kentucky. specializing in NURSE PRACTITIONER. They hold the professional credentials N.P. They hold a License No. 3005770 (KY). The NPI Number for LORETTA SUE WILSON (N.P) is 1407002603

Main info

Female
18 Years Of Experience
Accepts Medicare Assignment
Name
LORETTA SUE WILSON (N.P)
NPI
1407002603
Phone
(606) 526-9005
Address
39 CUMBERLAND GAP PLZ
Enumeration Date
7 August 2008
Last Update Date
10 December 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6065269005
Graduation Year
2008 (18 years ago)
PAC ID
1951467331
Group Practice PAC ID
3870654064
Professional Enrollment ID
I20090408000410
Address ID
KY407016425CO14662EXXX600
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:17State licenses:2Digital endpointsOther names

7,347 NURSE PRACTITIONER in KY

Provider Addresses for LORETTA SUE WILSON (N.P)

  • 39 CUMBERLAND GAP PLZ

    GRAY, KY 407344536

    Phone: (606) 526-9005

    Fax: (606) 526-8606

    Type: Location

  • 1019, Cumberland Falls Highway, Corbin, Whitley County, Kentucky, 40701, United States

    SUITE B201

    CORBIN, KY 407012735

    Phone: (606) 526-9005

    Fax: (606) 526-8606

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $154.

Total Amount is formed as General ($154) + Research ($0) + Ownership ($0) = $154.

Last reported payment date: 2024-01-30 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($71).

Total Amount

$154

General + Research + Ownership

Payments

6

Total payment records

General Amount

$154

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-30

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-04-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090408000410INurse PractitionerKYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 40734)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3870654064View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YVA
Nurse PractitionerKY
Family PracticeKY
Nurse PractitionerKY
-KY
Physician AssistantKY
Nurse PractitionerKY
-KY
-KY
Nurse PractitionerTN

Reviews

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Frequently asked questions

Does LORETTA SUE WILSON (N.P) have a public NPI I can cite?
Public records show LORETTA SUE WILSON (N.P) under NPI 1407002603.
Does the public listing show LORETTA SUE WILSON (N.P) as active?
LORETTA SUE WILSON (N.P)'s NPI record reflects an active status in NPPES.
What type of care does LORETTA SUE WILSON (N.P) provide?
LORETTA SUE WILSON (N.P)'s profile centers on Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Which community is linked to LORETTA SUE WILSON (N.P)?
LORETTA SUE WILSON (N.P) shows a connection to Gray, Kentucky in registry-derived data.
Why is information missing for LORETTA SUE WILSON (N.P)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.