John Wells Wilson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

190110 Issued in OR

Practice address

1590 East 13TH Ave.
Eugene, OR 97403-1217

Phone

(541) 346-2770

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• University of Oregon

  • Clinic/Center
  • Eugene, OR
  • NPI 1760435234
  NPD (past)
• DCHS Medical Foundation

  • Internal Medicine Physician
  • San Jose, CA
  • NPI 1740597368

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1184713463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85100 CLOVERDALE RD",
            "city": "CRESWELL",
            "state": "OR",
            "postal_code": "974269838",
            "telephone_number": "415-279-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 EAST 13TH AVE.",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974031217",
            "telephone_number": "541-346-2770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Sullivan Ave",
            "address_2": "Room 503",
            "address_purpose": "LOCATION",
            "city": "Daly City",
            "state": "CA",
            "postal_code": "940152228",
            "country_code": "US",
            "telephone_number": "650-994-9090",
            "fax_number": "650-994-9093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JOHN",
        "middle_name": "WELLS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "190110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Lynn Wilson, LMT
• Elizabeth Amy Wilson, ATC
• Erica Wilson, MS, QMHP, LPC
• Jennifer Susan Wilson, RN
• Jessica Wilson, RD
• Kiana B Wilson
• Kimberly Louise Wilson
• Kirk F Wilson, FRA
• Kristin Kathleen Wilson, RN
• Laura KS Wilson, LCSW

• Family Medicine Physician in Eugene, OR
• Providers in Eugene, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; 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.