NPIMap

Individual provider Active NPI

James Edward Wilkerson III, M. D.

  • Family Medicine Physician
  • Sherwood, AR
National Provider Identifier
1083934632
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E7430 Issued in AR
Practice address
7709 Highway 107
Sherwood, AR 72120-4661
Phone
(501) 552-7262
Fax
(501) 552-5317
NPI assigned
Jun 6, 2010
Last updated
Jan 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X E7430 AR Primary

Addresses

Primary practice location

7709 Highway 107
Sherwood, AR 72120-4661

Mailing address

7709 Highway 107
Sherwood, AR 72120-4661
Phone (501) 552-7262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120928000633 AR Practitioner - Family PracticePractitioner - Emergency Medicine 9537318969 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical GroupGroup PAC ID 5698758803, 237 clinicians

Practice addresses (Care Compare)

7709 Hwy 107
Sherwood, AR 72120-4661
Phone (501) 552-7269

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E7430ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group Family Medicine CurrentSince Jun 1, 2013 Accepting new patients
St Vincent Physician Clinics LLC Family Medicine CurrentSince Jan 1, 2016 Accepting new patients

Locations

16221 Saint Vincent Way
Little Rock, AR 72223
Phone (501) 221-0888

7709 Highway 107
Sherwood, AR 72120
Phone (501) 552-7262

Interoperability endpoints

  • Direct secure messaging: james.wilkerson@svmgs.eclinicaldirectplus.com
  • Direct secure messaging: jwilkerson458875@direct.stlukeshealth.org

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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1275782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1083934632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7709 HIGHWAY 107",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721204661",
            "telephone_number": "501-552-7262",
            "fax_number": "501-907-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7709 HIGHWAY 107",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721204661",
            "telephone_number": "501-552-7262",
            "fax_number": "501-552-5317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-06",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E7430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherwood, AR

Sources for this page

Verify at the official NPI Registry.