Individual provider Active NPI

Candice Lynn Wilson, M.D.

  • Diagnostic Radiology Physician
  • Knoxville, TN
National Provider Identifier
1215997028
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0000037867 Issued in TN
Practice address
1521 Downtown West Blvd
Knoxville, TN 37919-5407
Phone
(865) 545-4592
Fax
(865) 693-8978
NPI assigned
Mar 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME94386 FL
Specialist 174400000X 055042 GA
Specialist 174400000X 0000037867 TN
Diagnostic Radiology Physician 2085R0202X 0000037867 TN Primary
Specialist 174400000X 00027018 AL

Addresses

Primary practice location

1521 Downtown West Blvd
Knoxville, TN 37919-5407

Mailing address

Jhqmc Mountain Home VA; Radiology Department
PO Box 4000
Mountain Home, TN 37684-4000
Phone (423) 926-1171

Other identifiers 5

IdentifierTypeStateIssuer
1882432OtherTNFIRST HEALTH
807388100MedicaidGA
9495633OtherTNCIGNA
7100041970MedicaidKY
4184755OtherTNBCBS OF TN

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

LicenseStateTypeSpecialty
00027018ALMDSpecialist
ME94386FLMDSpecialist
055042GAMDSpecialist
0000037867TNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ty Cobb Healthcare System Past Accepting new patients
Ty Cobb Healthcare System, Inc Specialist Past Accepting new patients
Reddy Solutions, Inc. Diagnostic Radiology Past Accepting new patients
Reddy Solutions Inc Specialist Past Accepting new patients
Hospital Authority of Jeff Davis County Georgia Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1215997028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "JHQMC MOUNTAIN HOME VA; RADIOLOGY DEPARTMENT",
            "address_2": "PO BOX 4000",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376844000",
            "telephone_number": "423-926-1171",
            "fax_number": "429-979-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 DOWNTOWN WEST BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195407",
            "telephone_number": "865-545-4592",
            "fax_number": "865-693-8978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CANDICE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME94386",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "055042",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "0000037867",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "0000037867",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "00027018",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1882432",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807388100",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9495633",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100041970",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "4184755",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.