Individual provider Active NPI

Matthew Hunter Wilson, M.D., PH.D.

  • Nephrology Physician
  • Nashville, TN
National Provider Identifier
1073639886
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
37400 Issued in TN
Practice address
1161 21St Ave S
MCN S-3223
Nashville, TN 37232-2372
Phone
(615) 873-6842
NPI assigned
Mar 22, 2007
Last updated
Mar 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X M7761 TX
Nephrology Physician 207RN0300X 37400 TN Primary

Addresses

Primary practice location

1161 21St Ave S
MCN S-3223
Nashville, TN 37232-2372

Mailing address

3841 Green Hills Village Dr Ste 200
Nashville, TN 37215-2691

Other practice location 1

1310 24th Ave S
Nashville, TN 37212-2637
Phone (615) 873-7480

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mwilson36251@direct.vumc.org Direct

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, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
37400TNMDNephrology Physician

Interoperability endpoints

  • Direct secure messaging: mwilson36251@direct.vumc.org

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1073639886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 21ST AVE S",
            "address_2": "MCN S-3223",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372322372",
            "telephone_number": "615-873-6842"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 24th Ave S",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372122637",
            "country_code": "US",
            "telephone_number": "615-873-7480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MATTHEW",
        "middle_name": "HUNTER",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "M7761",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TN",
            "license": "37400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwilson36251@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "1161 21st Ave S",
            "address_2": "MCN S-3223",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372322372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.