CMS-1500 Box 24J / 33a • NPI
1174263206
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LF0000X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family
Box 32 Service Location & ZIP+4
401 N MAIN ST, ROANOKE, IL, 61561-7585
✓ 9-Digit EDI 837 ZIP+4 (61561-7585)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1174263206 (HAYLEY ELIZABETH WILSON) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1174263206)
Medicare Beneficiaries
43
Total Billed Services
67
Distinct CPT/HCPCS Codes
20
Medicare Allowed Total
$3,754.22
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 36 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Atorvastatin Calcium Atorvastatin Calcium | 12 | <11 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1174263206 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | HAYLEY ELIZABETH WILSON |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family NUCC Code: 363LF0000X (Nurse Practitioner, Family) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 401 N MAIN ST, ROANOKE, IL, 61561-7585 |
| Practice Telephone / Fax | Tel: (309) 923-2661 |
| Administrative Mailing Address | 401 N MAIN ST, ROANOKE, IL, 61561-7585 |
| Enumeration & Last Sync | Enumerated: 2022-03-29 | CMS Record Updated: 2022-03-29 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LF0000X)
What Does Taxonomy Code 363LF0000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LF0000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (HAYLEY ELIZABETH WILSON)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363LF0000X — Nurse Practitioner, FamilyPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family | State: IL | License: 209024824 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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