Wilkens Medical Group Inc.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

WILKENS MEDICAL GROUP INC.

Practice address

131 Hospital LN
Jellico, TN 37762-4404

Phone

(423) 784-7269

Fax

(423) 784-3708

NPI assigned

Jan 17, 2007

Last updated

Nov 20, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Debra J Sharp

Title

Administration

Phone

(423) 784-3667

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574208000000",
    "number": "1114079316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377620028",
            "telephone_number": "423-784-7269",
            "fax_number": "423-784-3708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 HOSPITAL LN",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377624404",
            "telephone_number": "423-784-7269",
            "fax_number": "423-784-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILKENS MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2019-11-20",
        "status": "A",
        "authorized_official_last_name": "SHARP",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATION",
        "authorized_official_telephone_number": "423-784-3667"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65938771",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3717798",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shonda Lynn Tucker, APRN
• Susanne Urich, RN
• Marybelle Walden, CHIROPRACTOR DC
• Walgreen Co (Walgreens #18950)
• Natalie Ruth Wilbanks, PA-C
• Darryl John Wilkens, M.D.
• Windham Drug Jellico, Inc (Windham Drug Jellico)
• Rebekkah M Witten, LCSW
• Daniel Eugene Yoder Jr., MD

• Surgery Physician in Jellico, TN
• Providers in Jellico, TN by specialty
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; 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.