Active NPI
Christopher Ray Wilson, PH.D.
- Clinical Psychologist
- Fort Campbell, KY
National Provider Identifier
1053550343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1537
- Practice address
- 650 Joel Dr
Fort Campbell, KY 42223-8355 - Phone
- (270) 798-1112
- NPI assigned
- Feb 11, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1537 | AL | Primary |
Addresses
Primary practice location
650 Joel Dr
Fort Campbell, KY 42223-8355
Mailing address
1773 Ellie Piper Cir
Clarksville, TN 37043-1647
Phone (931) 302-1843
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1537 | AL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775779200000",
"number": "1053550343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1773 ELLIE PIPER CIR",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370431647",
"telephone_number": "931-302-1843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 JOEL DR",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "422238355",
"telephone_number": "270-798-1112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CHRISTOPHER",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-02-11",
"last_updated": "2026-04-10",
"certification_date": "2026-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AL",
"license": "1537",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Campbell, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.