Jared Wilson, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

15157 Issued in TX

Practice address

1150 E Eldorado Pkwy Ste 300
Little Elm, TX 75068-5504

Phone

(972) 292-9863

Fax

(972) 292-9861

NPI assigned

Aug 25, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

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 and National Provider Directory roles.

• Core Strength Wellness Center

  • Clinic/Center
  • Prosper, TX
  • NPI 1588391221
  NPD Authorized official
• Coos Bay Chiropractic & Wellness Center Inc

  • Chiropractor
  • North Bend, OR
  • NPI 1518115781
  NPD (past)

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1104059104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 E ELDORADO PKWY STE 300",
            "city": "LITTLE ELM",
            "state": "TX",
            "postal_code": "750685504",
            "telephone_number": "972-292-9863",
            "fax_number": "972-292-9861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 E ELDORADO PKWY STE 300",
            "city": "LITTLE ELM",
            "state": "TX",
            "postal_code": "750685504",
            "telephone_number": "972-292-9863",
            "fax_number": "972-292-9861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "498 Harlow Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974771339",
            "country_code": "US",
            "telephone_number": "541-341-1414",
            "fax_number": "541-653-8570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JARED",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3956",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "OR",
            "license": "3956",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "TX",
            "license": "15157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500707661",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paige Whittle
• Courtney Wilkerson, LPC
• Keara Williams, NP
• Aaron Wilson
• Clinton Wilson, PTA
• Wink Eye Care, PLLC
• Jill Ellen Wolf, MD
• Kimberly Sue Wolf, FNPC
• June Christine Won, OD
• Woodlake Family Dentistry

• Sports Physician Chiropractor in Little Elm, TX
• Providers in Little Elm, TX by specialty
• Sports Physician Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.