Active NPI
Margaret M Wilson, MD
- Geriatric Medicine (Internal Medicine) Physician
- Saint Louis, MO
National Provider Identifier
1063420818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- 2000153664
- Practice address
- 3660 Vista Ave
Saint Louis, MO 63110-2540 - Phone
- (314) 977-8462
- Fax
- (314) 268-5108
- NPI assigned
- Aug 4, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 2000153664 | MO | Primary |
Addresses
Primary practice location
3660 Vista Ave
Saint Louis, MO 63110-2540
Mailing address
3691 Rutger St
Provider Enrollment
Saint Louis, MO 63110-2515
Phone (314) 977-6828
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 75334 | Other | HEALTH ALLIANCE | |
| 126692 | Other | BCBS | |
| 449182 | Other | HEALTHLINK | |
| 4553038 | Other | AETNA | |
| 234125 | Other | HARMONY |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Granite City Clinic Corp | Past | Accepting new patients | |
| Granite City Physicians Corp | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Granite City Anesthesia
- Certified Registered Nurse Anesthetist
- Granite City, IL
- NPI 1003892464
-
- Clinical Medical Laboratory
- Granite City, IL
- NPI 1508983214
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063420818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3691 RUTGER ST",
"address_2": "PROVIDER ENROLLMENT",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631102515",
"telephone_number": "314-977-6828",
"fax_number": "314-977-6777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3660 VISTA AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631102540",
"telephone_number": "314-977-8462",
"fax_number": "314-268-5108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MARGARET",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "MO",
"license": "2000153664",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE",
"identifier": "75334",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "126692",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "449182",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4553038",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARMONY",
"identifier": "234125",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.