Casey S Wilson, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

7244-15 Issued in WI

Practice address

1931 N 8TH St
Sheboygan, WI 53081-2740

Phone

(920) 783-6633

Fax

(920) 783-6635

NPI assigned

May 19, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: cwilson364064@direct.ochin.org

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401235200000",
    "number": "1164833562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1931 N 8TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530812740",
            "telephone_number": "920-783-6633",
            "fax_number": "920-783-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 N 8TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530812740",
            "telephone_number": "920-783-6633",
            "fax_number": "920-783-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CASEY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-19",
        "last_updated": "2014-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "7244-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robyn Ann Williams, LPC
• Robert T Willis, MD
• Willowglen Academy - Wilson
• Willowglen Academy-Wisconsin, Inc.
• Matthew Reed Willsey, D.O.
• Christa Wilson, PHARMD
• Joseph Devan Wilson, OD
• Michelle L Wilson, APNP
• Amy Nicole Wimmer, DPT, PT
• Elizabeth Wimmler

• Dentist in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.