Individual provider Active NPI

Darrel Lenard Wilson, M.D.

  • Psychiatry Physician
  • Memphis, TN
National Provider Identifier
1114071370
Registry record updated Dec 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
031886 Issued in TN
Practice address
951 Court Ave
Memphis, TN 38103-2813
Phone
(901) 577-1800
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 031886 TN Primary

Addresses

Primary practice location

951 Court Ave
Memphis, TN 38103-2813

Mailing address

7948 Winchester Rd Ste 109
PMB 135
Memphis, TN 38125-2311
Phone (901) 624-3933

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

State licenses

LicenseStateTypeSpecialty
031886TNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Healthcare System, Inc Past Accepting new patients
Darrel L Wilson P.C. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/allihcs-9d312177

Organizations & group practices 2

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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230508800000",
    "number": "1114071370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7948 WINCHESTER RD STE 109",
            "address_2": "PMB 135",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381252311",
            "telephone_number": "901-624-3933",
            "fax_number": "901-624-5044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 COURT AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032813",
            "telephone_number": "901-577-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DARREL",
        "middle_name": "LENARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2008-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "031886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.