Active NPI
Stephen Lloyd Wilson, DC
- Chiropractor
- Lexington, KY
National Provider Identifier
1144313842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4883
- Practice address
- 1412 N Broadway
Ste 206
Lexington, KY 40505-3157 - Phone
- (859) 543-0252
- Fax
- (859) 543-0698
- NPI assigned
- Oct 2, 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4883 | KY | Primary |
Addresses
Primary practice location
1412 N Broadway
Ste 206
Lexington, KY 40505-3157
Mailing address
1412 N Broadway
Ste 206
Lexington, KY 40505-3157
Phone (859) 543-0252
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 382161 | Other | KY | ANTHEM |
| 641489 | Other | KY | AM CHI NETWORK |
| 5795695 | Other | KY | AETNA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4883 | KY | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chiroworks Alt. Pain & Rehab, LLC | Chiropractor | 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.
-
- Chiropractor
- Lexington, KY
- NPI 1205267168
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283817600000",
"number": "1144313842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1412 N BROADWAY",
"address_2": "STE 206",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405053157",
"telephone_number": "859-543-0252",
"fax_number": "859-543-0698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1412 N BROADWAY",
"address_2": "STE 206",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405053157",
"telephone_number": "859-543-0252",
"fax_number": "859-543-0698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "STEPHEN",
"middle_name": "LLOYD",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2010-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "KY",
"license": "4883",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "382161",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AM CHI NETWORK",
"identifier": "641489",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5795695",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.