Active NPI
Paul D Wilson
- Psychologist
- Overland Park, KS
National Provider Identifier
1215221916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- #301
- Practice address
- 8575 West 110TH Street
304
Overland Park, KS 66210 - Phone
- (913) 345-9333
- Fax
- (913) 345-9335
- NPI assigned
- May 31, 2011
- Last updated
- May 31, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | #301 | KS | Primary |
Addresses
Primary practice location
8575 West 110TH Street
304
Overland Park, KS 66210
Mailing address
8575 West 110TH Street
304
Overland Park, KS 66210
Phone (913) 345-9333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| #301 | KS | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306800000000",
"number": "1215221916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8575 WEST 110TH STREET",
"address_2": "304",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "66210",
"telephone_number": "913-345-9333",
"fax_number": "913-345-9335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8575 WEST 110TH STREET",
"address_2": "304",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "66210",
"telephone_number": "913-345-9333",
"fax_number": "913-345-9335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "PAUL",
"middle_name": "D",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-31",
"last_updated": "2011-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "KS",
"license": "#301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.