Individual provider Active NPI

Matthew C Wilson, D.O.

  • Family Medicine Physician
  • Seymour, IN
National Provider Identifier
1174839054
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02005993A Issued in IN
Practice address
Schneck Primary Care - Jackson Park
1124 Medical Place
Seymour, IN 47274
Phone
(812) 522-1613
Fax
(812) 522-6694
NPI assigned
Aug 30, 2010
Last updated
Jul 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02005993A IN Primary

Addresses

Primary practice location

Schneck Primary Care - Jackson Park
1124 Medical Place
Seymour, IN 47274

Mailing address

Schneck Primary Care - Jackson Park
1124 Medical Place
Seymour, IN 47274
Phone (812) 522-1613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.97 of 100Reported as apm
Quality
85.1
Promoting interoperability
94.69
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
02005993AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seymour Indiana Pathologists, Inc Past Accepting new patients
Major Hospital Past Accepting new patients
Jackson County Schneck Memorial Hospital PastSince Mar 1, 2021 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1174839054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SCHNECK PRIMARY CARE - JACKSON PARK",
            "address_2": "1124 MEDICAL PLACE",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "47274",
            "telephone_number": "812-522-1613",
            "fax_number": "812-522-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SCHNECK PRIMARY CARE - JACKSON PARK",
            "address_2": "1124 MEDICAL PLACE",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "47274",
            "telephone_number": "812-522-1613",
            "fax_number": "812-522-6694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MATTHEW",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-30",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02005993A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seymour, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.