Active NPI
Candice Lynn Wilson, M.D.
- Diagnostic Radiology Physician
- Knoxville, TN
National Provider Identifier
1215997028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 0000037867
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1882432 | Other | TN | FIRST HEALTH |
| 807388100 | Medicaid | GA | |
| 9495633 | Other | TN | CIGNA |
| 7100041970 | Medicaid | KY | |
| 4184755 | Other | TN | BCBS 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
| License | State | Type | Specialty |
|---|---|---|---|
| 00027018 | AL | MD | Specialist |
| ME94386 | FL | MD | Specialist |
| 055042 | GA | MD | Specialist |
| 0000037867 | TN | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Rural Health Clinic/Center
- Hazlehurst, GA
- NPI 1912379082
-
- Specialist
- Atlanta, GA
- NPI 1215980594
-
- Diagnostic Radiology Physician
- Atlanta, GA
- NPI 1376707109
-
- Rural Acute Care Hospital
- Royston, GA
- NPI 1083711691
-
- Specialist
- Carnesville, GA
- NPI 1245533132
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.