Active NPI
Kathryn a. S. Wilson DO LLC
- Family Medicine Physician
- Springboro, OH
National Provider Identifier
1184735730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- KATHRYN A. S. WILSON DO LLC
- Practice address
- 32 S Richards Run
Springboro, OH 45066-8003 - Phone
- (937) 748-9051
- Fax
- (937) 748-9054
- NPI assigned
- Aug 31, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kathryn A. Wilson, DO
- Title
- Owner
- Phone
- (937) 748-9051
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
32 S Richards Run
Springboro, OH 45066-8003
Mailing address
70 Southfield CT
Springboro, OH 45066-9268
Phone (800) 357-5728
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2346572 | Medicaid | OH | |
| CK6330 | Other | OH | RAILROAD MEDICARE |
| 150287 | Other | OH | UNITED MINE WORKERS |
National Provider Directory
National Provider DirectoryLocations
32 S Richards Run
Springboro, OH 45066
Phone (937) 748-9051
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Lebanon, OH
- NPI 1699854018
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1208822400000",
"number": "1184735730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 SOUTHFIELD CT",
"city": "SPRINGBORO",
"state": "OH",
"postal_code": "450669268",
"telephone_number": "800-357-5728",
"fax_number": "937-291-2962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32 S RICHARDS RUN",
"city": "SPRINGBORO",
"state": "OH",
"postal_code": "450668003",
"telephone_number": "937-748-9051",
"fax_number": "937-748-9054"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KATHRYN A. S. WILSON DO LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-31",
"last_updated": "2008-04-22",
"status": "A",
"authorized_official_last_name": "WILSON",
"authorized_official_first_name": "KATHRYN",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "937-748-9051",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2346572",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CK6330",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED MINE WORKERS",
"identifier": "150287",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springboro, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.