Active NPI
Wayne Tilson, M.D.
- Emergency Medicine Physician
- Lawrence, KS
National Provider Identifier
1104923739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 17945
- Practice address
- 2904 Gill Ave
Lawrence, KS 66047-3038 - Phone
- (785) 841-9419
- NPI assigned
- Sep 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 17945 | KS | Primary |
Addresses
Primary practice location
2904 Gill Ave
Lawrence, KS 66047-3038
Mailing address
2904 Gill Ave
Lawrence, KS 66047-3038
Phone (785) 841-9419
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17945 | Other | KS | MEDICAL LICENSE NUMBER |
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 Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Kansas Medical Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Great Bend, KS
- NPI 1467402040
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104923739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2904 GILL AVE",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660473038",
"telephone_number": "785-841-9419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2904 GILL AVE",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660473038",
"telephone_number": "785-841-9419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILSON",
"first_name": "WAYNE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "KS",
"license": "17945",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE NUMBER",
"identifier": "17945",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.