Robert Wilson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2591 Issued in TN

Practice address

132A N Central Ave
Centerville, TN 37033

Phone

(931) 729-4001

Fax

(931) 729-4081

NPI assigned

May 7, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Pridemore Family Chiropractic PC

  • Chiropractor
  • Johnson City, TN
  • NPI 1063614683
  NPD (past)

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

{
    "created_epoch": "1336348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1144589458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "CENTERVILLE",
            "state": "TN",
            "postal_code": "370330099",
            "telephone_number": "931-729-4001",
            "fax_number": "931-729-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132A N CENTRAL AVE",
            "city": "CENTERVILLE",
            "state": "TN",
            "postal_code": "37033",
            "telephone_number": "931-729-4001",
            "fax_number": "931-729-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ROBERT",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-07",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TENNESSEE",
            "identifier": "6128617",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES - PLLC NPI",
            "identifier": "1366957656",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Univita of Tennessee, Inc
• John E Van Cleve III, DDS
• Walgreen Co
• Loretta Lynne Wheeless, RPH
• Kelly Marie Wilson, LPN
• Sharon Garrett Wilson, NA
• Courtney Yocum, LCSW

• Chiropractor in Centerville, TN
• Providers in Centerville, TN by specialty
• Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.