John Roosevelt Wilson, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I0600163 Issued in OH

Practice address

1955 Ohio Dr
Grove City, OH 43123-4835

Phone

(614) 257-5800

Fax

(614) 257-5801

NPI assigned

Feb 20, 2009

Last updated

Feb 20, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

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  Clinical

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• River's Edge Counseling, PLLC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1548958168

  Clinical

  NPD

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

{
    "created_epoch": "1235088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235088000000",
    "number": "1093955775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 WIND RUSH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432134439",
            "telephone_number": "614-986-8911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 OHIO DR",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431234835",
            "telephone_number": "614-257-5800",
            "fax_number": "614-257-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JOHN",
        "middle_name": "ROOSEVELT",
        "name_prefix": "Mr.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-20",
        "last_updated": "2009-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0600163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Michael Williams, MSN, APRN, FNP-C
• Deja Nichole Williams, LSW
• Abigail Willis
• Jackie Willms
• Denise Claudia Wilson, QMHS
• Julia Wilson, CNP MSN
• Molly Ann Wilson, M.D.
• Patrice Wilson, BSSW
• Robert E Wilson III
• Sherri Kay Wilson, LPC, CRC,CDCA

• Clinical Social Worker in Grove City, OH
• Providers in Grove City, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.