Anjeli Kumari Wilson, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301077536 Issued in MI

Practice address

426 22ND Ave E
Springfield, TN 37172-3711

Phone

(615) 384-0600

Fax

(615) 384-0645

NPI assigned

Apr 25, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Vip Midsouth, LLC

  • Rural Health Clinic/Center
  • Pleasant View, TN
  • NPI 1336722669

  Corporate Director

  CMS ownership
• Vip Midsouth, LLC

  • Rural Health Clinic/Center
  • Springfield, TN
  • NPI 1528641859

  Corporate Director

  CMS ownership
• Vip Midsouth, LLC

  • Rural Health Clinic/Center
  • Lafayette, TN
  • NPI 1588247811

  Corporate Director

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vip Midsouth, LLC

  • Pediatrics Physician
  • Gallatin, TN
  • NPI 1487737912
  Medicare reassignment NPD
• Vip Midsouth, LLC

  • Rural Health Clinic/Center
  • Pleasant View, TN
  • NPI 1336722669
  NPD

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1083833347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 HARTSVILLE PIKE",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370662523",
            "telephone_number": "615-451-9246",
            "fax_number": "615-575-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 22ND AVE E",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371723711",
            "telephone_number": "615-384-0600",
            "fax_number": "615-384-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ANJELI",
        "middle_name": "KUMARI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301077536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anjeli.wilson@vipms.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "426 22nd Ave E",
            "city": "Springfield",
            "state": "TN",
            "country_code": "US",
            "postal_code": "371723711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert W Williams, CRNA
• Sara Nichole Williams, RN
• Teresa Marie Williams, M.D.
• Tiffany D Williams, CNM
• Wilson Mental Health, PLLC
• Jessica Wilson, LPC/MHSP, NCC
• Nicholas Colt Winchester, NP
• Winfield H Winegar, PA
• Aiden Christine Winford, M.S.
• Johna Wix, FNP-C

• Pediatrics Physician in Springfield, TN
• Providers in Springfield, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.