Pamela Eileen Wilson, D.C.

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

3851 Issued in NJ

Practice address

130 Maple Ave
Suite 7a
Red Bank, NJ 07701-1734

Phone

(732) 842-7004

Fax

(732) 842-8799

NPI assigned

Apr 8, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 1989

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wilson Physical Medicine LLC

  • Rehabilitation Chiropractor
  • Red Bank, NJ
  • NPI 1710273503
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1033232830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 MAPLE AVE",
            "address_2": "SUITE 7A",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011734",
            "telephone_number": "732-842-7004",
            "fax_number": "732-842-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 MAPLE AVE",
            "address_2": "SUITE 7A",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011734",
            "telephone_number": "732-842-7004",
            "fax_number": "732-842-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "PAMELA",
        "middle_name": "EILEEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-08",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "NJ",
            "license": "3851",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "NY",
            "license": "011256",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD INS ID#",
            "identifier": "P413708",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Lee Williams, LAC
• Kiera J Williams, MSW, LSW
• Annette Lynne Wilmott, D.O.
• Wilson Physical Medicine LLC
• Kedaar Bernard Wilson
• Wind of Change Mental Health Counseling LLC
• Robert E Wold, M.D.
• Brianna Wolff, DPT
• Alfred Francis Wolkomir, M.D.
• Womens Health Alliance of NJ

• Rehabilitation Chiropractor in Red Bank, NJ
• Providers in Red Bank, NJ by specialty
• Rehabilitation Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.