John David Wilson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

150495 Issued in OR

Practice address

495 SW Ramsey Ave
Grants Pass, OR 97527-5681

Phone

(541) 476-6644

NPI assigned

Nov 18, 2008

Last updated

Jul 6, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Family Practice

Education

Loma Linda University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Grants Pass Clinic LLPGroup PAC ID 9234123977, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Home Health Care Home health agency, Grants Pass, OR, CCN 387143
• Accentcare Home Health of Rogue Valley, LLC Home health agency, Medford, OR, CCN 387098
• Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002
• Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: johnwilson@gpc.allscriptsdirect.net
• Direct secure messaging: johnwilson@grantspass.allscriptsdirect.net

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.

• Grants Pass Clinic LLP

  • Internal Medicine Physician
  • Grants Pass, OR
  • NPI 1760418032

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809
  Medicare reassignment NPD

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

• Accentcare Home Health of Rogue Valley, LLC

  • Home Health Agency
  • Medford, OR
  • NPI 1912228727
  Care Compare affiliation
• Asante

  dba Asante Rogue Regional Medical Center

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Care Compare affiliation
• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809
  Care Compare affiliation
• Rogue River Healthcare LLC

  dba Riverside Home Health Care

  • Home Health Agency
  • Grants Pass, OR
  • NPI 1841805223
  Care Compare affiliation

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

{
    "created_epoch": "1226966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1104071224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 SW RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275681",
            "telephone_number": "541-476-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 SW RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275681",
            "telephone_number": "541-476-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-18",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "TN",
            "license": "MD37095",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "150495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500622415",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David R Willing, D.C.
• Clinton David Willoughby, CADC II
• Asani Wilson, PT
• Desy P Wilson, DDS, MS
• Erin Wilson, MD
• Latara A Wilson, MA, CMHA
• William Lloyd Wilson
• Ronald Wayne Winfrey
• Troy Winger
• Sarah Anne Witesman, PA-C

• Family Medicine Physician in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.