NPIMap

Individual provider Active NPI

Mark E Wilson, MD

  • Gastroenterology Physician
  • Jackson, MS
National Provider Identifier
1184612368
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
15570 Issued in MS
Practice address
971 Lakeland Dr Ste 250
Jackson, MS 39216-4620
Phone
(601) 200-5550
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 15570 MS
Gastroenterology Physician 207RG0100X 15570 MS Primary

Addresses

Primary practice location

971 Lakeland Dr Ste 250
Jackson, MS 39216-4620

Mailing address

2510 Lakeland Dr
Flowood, MS 39232-9513
Phone (601) 355-1234

Other practice location 1

2510 Lakeland Dr
Flowood, MS 39232-9513
Phone (601) 355-1234

Other identifiers 1

IdentifierTypeStateIssuer
00118644MedicaidMS

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other
Direct Messaging Address mwilson2548715@direct.casso.us.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, MT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100818000060 MS Practitioner - Gastroenterology 0244236800 Reassigns benefits to 2 organizations
I20250428003236 MT Practitioner - Gastroenterology 0244236800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastrointestinal Associates PAGroup PAC ID 5294795241, 45 clinicians
Billings ClinicGroup PAC ID 6002993516, 814 clinicians

Practice addresses (Care Compare)

106 Highland Way
Madison, MS 39110-6933

2510 Lakeland Dr
Flowood, MS 39232-9513
Phone 6013551234562

801 N 29TH St
Billings, MT 59101-0905
Phone (406) 238-2500

969 Lakeland Dr
Jackson, MS 39216-4606
Phone (601) 200-3100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy186
Upper gastrointestinal (GI) endoscopy for acid reflux145

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Associates, PA CurrentSince Dec 29, 1999 Accepting new patients
Billings Clinic Current Accepting new patients
Billings Clinic CurrentSince Apr 17, 2025 Accepting new patients
St. Dominic Medical Associates, LLC CurrentSince Apr 1, 2023 Accepting new patients
St. Dominic Medical Associates LLC Current Accepting new patients
Billings Clinic Internal Medicine CurrentSince Apr 17, 2025 Accepting new patients
Gastrointestinal Associates, P.a. Gastroenterology CurrentSince Dec 29, 1999 Accepting new patients
St Dominic Medical Associates LLC CurrentSince Apr 1, 2023 Accepting new patients
Billings Clinic Past Accepting new patients

Locations

2510 Lakeland Dr
Flowood, MS 39232
Phone (601) 355-1234

1421 N State St
Ste 203
Jackson, MS 39202
Phone (601) 355-1234

971 Lakeland Dr
Ste 250
Jackson, MS 39216
Phone (601) 200-4860

106 Highland Way
Ste 101
Madison, MS 39110
Phone (601) 355-1234

106 Highland Way
Ste 202
Madison, MS 39110
Phone (601) 200-3376

801 N 29th St
Billings, MT 59101
Phone (406) 238-2210

2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290

Interoperability endpoints

  • Direct secure messaging: mwilson2548715@direct.casso.us.com
  • Direct secure messaging: giamwilson@directaddress.net
  • Direct secure messaging: mwilson219390@ummc.direct-ci.com

Organizations & group practices 9

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1184612368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 LAKELAND DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329513",
            "telephone_number": "601-355-1234",
            "fax_number": "601-326-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR STE 250",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164620",
            "telephone_number": "601-200-5550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2510 Lakeland Dr",
            "address_purpose": "LOCATION",
            "city": "Flowood",
            "state": "MS",
            "postal_code": "392329513",
            "country_code": "US",
            "telephone_number": "601-355-1234",
            "fax_number": "601-326-3559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARK",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "15570",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MS",
            "license": "15570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00118644",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "971 Lakeland Dr Ste 250",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392164620",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwilson2548715@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-EPIC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mwilson2548715@direct.casso.us.com",
            "address_1": "971 Lakeland Dr Ste 250",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392164620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.