Active NPI
Jeffrey Kent Wilson, M.D.
- Orthopaedic Surgery Physician
- Mechanicsville, VA
National Provider Identifier
1215978754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 101035718
- Practice address
- 8200 Meadowbridge Rd
Suite 200
Mechanicsville, VA 23116-2331 - Phone
- (804) 730-2121
- Fax
- (804) 730-0563
- NPI assigned
- Jun 8, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Reconstructive Orthopaedic Surgery Physician | 207XS0114X | 101035718 | VA | |
| Orthopaedic Surgery Physician | 207X00000X | 101035718 | VA | Primary |
Addresses
Primary practice location
8200 Meadowbridge Rd
Suite 200
Mechanicsville, VA 23116-2331
Mailing address
1115 Boulders Pkwy
Suite 200
North Chesterfield, VA 23225-4067
Phone (804) 560-5595
Other identifiers 18
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006403379 | Medicaid | VA | |
| 285655 | Other | VA | SOUTHERN HEALTH |
| 32147 | Other | VA | SH CARENET |
| 540885859 | Other | VA | CORVEL |
| 1215978754 | Medicaid | VA | |
| 540885859 | Other | VA | FOCUS |
| 540885859 | Other | VA | PRIVATE HEALTHCARE SYSTEM |
| 0900108 | Other | VA | UNITED HEALTHCARE |
| 540885859 | Other | VA | COMPMANAGEMENT |
| 05367828 | Other | VA | AETNA HMO |
| 200020605 | Other | VA | RAILROAD MEDICARE |
| 46427 | Other | VA | OPTIMA HEALTH |
| 540885859 | Other | VA | C&O EMPLOYEES HEALTHCARE |
| 052664 | Other | VA | ANTHEM HEALTHKEEPERS |
| 540885859 | Other | VA | FIRST HEALTH/CCN |
| 2138346 | Other | VA | UNITED HEALTHCARE MAMSI |
| 386544 | Other | VA | ANTHEM WEST END OPERATORY |
| 540885859 | Other | VA | CIGNA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101035718 | VA | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424304000000",
"number": "1215978754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1115 BOULDERS PKWY",
"address_2": "SUITE 200",
"city": "NORTH CHESTERFIELD",
"state": "VA",
"postal_code": "232254067",
"telephone_number": "804-560-5595",
"fax_number": "804-560-9029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8200 MEADOWBRIDGE RD",
"address_2": "SUITE 200",
"city": "MECHANICSVILLE",
"state": "VA",
"postal_code": "231162331",
"telephone_number": "804-730-2121",
"fax_number": "804-730-0563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JEFFREY",
"middle_name": "KENT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-08",
"last_updated": "2015-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0114X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
"state": "VA",
"license": "101035718",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "VA",
"license": "101035718",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "006403379",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTHERN HEALTH",
"identifier": "285655",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SH CARENET",
"identifier": "32147",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CORVEL",
"identifier": "540885859",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1215978754",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FOCUS",
"identifier": "540885859",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIVATE HEALTHCARE SYSTEM",
"identifier": "540885859",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0900108",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPMANAGEMENT",
"identifier": "540885859",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "05367828",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "200020605",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMA HEALTH",
"identifier": "46427",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "C&O EMPLOYEES HEALTHCARE",
"identifier": "540885859",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM HEALTHKEEPERS",
"identifier": "052664",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH/CCN",
"identifier": "540885859",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE MAMSI",
"identifier": "2138346",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM WEST END OPERATORY",
"identifier": "386544",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "540885859",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mechanicsville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.