Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jordan Nicole Wilson, PA

Individual provider Physician Assistant · NPI 1508322611

Jordan Nicole Wilson, PA is a Physician Assistant in Columbia, Missouri. Qualified in 2023, 3 years ago. Practices with Boone Physician Services LLC, a 240-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
3
Licensed in
MO
In the registry since
2019
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1 Hospital Dr
Columbia, MO 65212-0001
Phone: (573) 882-2568
Fax: (855) 903-0985
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2024003132 (MO)
Athletic Trainer Taxonomy 2255A2300X

Record details

NPI number1508322611
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 13, 2019
Last updated in NPPESJuly 21, 2026
Certification dateJuly 21, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Boone Physician Services Llc — 240 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Columbia