MS. MARJORIE S WILSON (NURSE PRACTITIONER) – Adult Health Nurse Practitioner, NPI 1639266067
Adult Health Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MS. MARJORIE S WILSON (NURSE PRACTITIONER)
4020 COPPER VW STE 104
TRAVERSE CITY, MI 496847041
Phone: (231) 421-6921
Fax: (231) 421-7852
Type: Location
1909 N Mitchell St
Cadillac, MI 49601
Phone: (231) 775-4401
Type: Location
815 BUSINESS PARK DR STE A
TRAVERSE CITY, MI 496868683
Phone: (231) 421-6921
Fax: (231) 421-7852
Type: Location
1909, North Mitchell Street, Haring, Haring Township, Wexford County, Michigan, 49601, United States
CADILLAC, MI 49601
Phone: (231) 775-4401
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2011-01-18
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110118000470 | I | Nurse Practitioner | MI | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 96372 | Injection of drug or substance under skin or into muscle | 12 | 11 | $0 |
Insurance plans in this area (ZIP 49684)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Nurse Practitioner | MI | |
| Family Practice | MI | |
| - | MI | |
| - | MI | |
| Nurse Practitioner | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| Nurse Practitioner | MI |
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