Fred Clayton Wilkins Jr., MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

22248 Issued in AL

Practice address

104 Anthem Ave
Herndon, VA 20170-5161

Phone

(703) 376-7296

NPI assigned

Dec 19, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Clay Wilkins Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1387411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1043631906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ANTHEM AVE",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705161",
            "telephone_number": "703-376-7296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 ANTHEM AVE",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705161",
            "telephone_number": "703-376-7296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "FRED",
        "middle_name": "CLAYTON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-19",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "22248",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AL",
            "license": "22248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLAY",
            "last_name": "WILKINS",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• John Whitney
• Kathi Whitten, LCSW
• Ronald Charles Wichin, DC
• Rohini Wijetilleke, M.D
• Courtney Wild
• Jio Williams
• Rebecca Williams, PTA
• Victoria Mary Williams
• Valerie Cherise Williamson, MD
• Austin William Charles Wills

• General Practice Physician in Herndon, VA
• Providers in Herndon, VA by specialty
• General Practice Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.