Active NPI
E Joan Wilson, CLS
- Medical Illustrator
- Dulce, NM
National Provider Identifier
1043479330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Illustrator
- License
- 9905528
- Practice address
- 12000 Stone Lake Road
Dulce, NM 87528 - Phone
- (505) 759-7238
- NPI assigned
- Jun 3, 2008
- Last updated
- Jun 4, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Illustrator | 246ZI1000X | 9905528 | KS | Primary |
Addresses
Primary practice location
12000 Stone Lake Road
Dulce, NM 87528
Mailing address
PO Box 1403
Ocean Park, WA 98640
Phone (360) 665-4599
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9905528 | KS | MD | Medical Illustrator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212537600000",
"number": "1043479330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1403",
"city": "OCEAN PARK",
"state": "WA",
"postal_code": "98640",
"telephone_number": "360-665-4599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12000 STONE LAKE ROAD",
"city": "DULCE",
"state": "NM",
"postal_code": "87528",
"telephone_number": "505-759-7238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "E",
"middle_name": "JOAN",
"name_prefix": "Ms.",
"credential": "CLS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-03",
"last_updated": "2008-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "246ZI1000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Illustration, Medical",
"state": "KS",
"license": "9905528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dulce, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.