Carrie Lynn Wilgus, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

4301073703 Issued in MI

Practice address

300 Meadow Run Drive
Hastings, MI 49058

Phone

(269) 818-1020

Fax

(269) 818-1266

NPI assigned

Apr 11, 2006

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AFAACA/Endpoint/AFAACA

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.

• Southside Pediatrics PC

  • Pediatrics Physician
  • Hastings, MI
  • NPI 1912252909
  NPD (past) Authorized official

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1174586978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MEADOW RUN DRIVE",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "49058",
            "telephone_number": "269-818-1020",
            "fax_number": "269-818-1266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEADOW RUN DRIVE",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "49058",
            "telephone_number": "269-818-1020",
            "fax_number": "269-818-1266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILGUS",
        "first_name": "CARRIE",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301073703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3500800182",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4123869",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• West Michigan Heart
• Christa Wetzel
• Emily Whisner
• William Wiering, DDS
• Steven George Wildern, M.D.
• Elizabeth M Wilson, RAC
• Samuel Wilson
• Steven Wilson
• Melissa M Winger, DO
• Caitlin Elise-Nosanov Winsor, OD

• Specialist in Hastings, MI
• Providers in Hastings, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2017; 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.