NPIMap

Individual provider Active NPI

James Cary Wilson, D.O.

  • Emergency Medicine Physician
  • Fort Smith, AR
National Provider Identifier
1093772592
Registry record updated Dec 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ARR-4100 Issued in AR
Practice address
7301 Rogers Ave.
Emergency Department
Fort Smith, AR 72903-4100
Phone
(479) 484-6241
Fax
(479) 484-6240
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ARR-4100 AR Primary
Family Medicine Physician 207Q00000X R4100 AR

Addresses

Primary practice location

7301 Rogers Ave.
Emergency Department
Fort Smith, AR 72903-4100

Mailing address

8524 S. 30TH Terrace
Fort Smith, AR 72908-8784
Phone (479) 649-0700

Other identifiers 3

IdentifierTypeStateIssuer
200013420AMedicaidOK
011986003MedicaidAR
119860003MedicaidAR

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
ARR-4100ARMDEmergency Medicine Physician
R4100ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Smith Hma, LLC Past Accepting new patients
Sparks Regional Medical Center Past Accepting new patients
St Edward Medical Services, Inc. Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228089600000",
    "number": "1093772592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8524 S. 30TH TERRACE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729088784",
            "telephone_number": "479-649-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 ROGERS AVE.",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034100",
            "telephone_number": "479-484-6241",
            "fax_number": "479-484-6240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JAMES",
        "middle_name": "CARY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2008-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "ARR-4100",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "R4100",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200013420A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011986003",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119860003",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; 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.