NPIMap

Organization Active NPI

Leroy a Wilson M D P C

  • Clinic/Center
  • Atlanta, GA
National Provider Identifier
1225204480
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
12594 Issued in GA
Legal business name
LEROY A WILSON M D P C
Practice address
315 Boulevard NE
Suite 316
Atlanta, GA 30312
Phone
(404) 659-1234
Fax
(404) 659-0640
NPI assigned
May 7, 2008
Last updated
May 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2008

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

Authorized official

Name
Dr. Leroy Augustus Wilson, M. D.NPI 1740218098
Title
President
Phone
(404) 659-1234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 12594 GA Primary

Addresses

Primary practice location

315 Boulevard NE
Suite 316
Atlanta, GA 30312

Mailing address

315 Boulevard NE
Suite 316
Atlanta, GA 30312
Phone (404) 659-1234

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1225204480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 BOULEVARD NE",
            "address_2": "SUITE 316",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30312",
            "telephone_number": "404-659-1234",
            "fax_number": "404-659-0640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 BOULEVARD NE",
            "address_2": "SUITE 316",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30312",
            "telephone_number": "404-659-1234",
            "fax_number": "404-659-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEROY A WILSON M D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "LEROY",
        "authorized_official_middle_name": "AUGUSTUS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-659-1234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "12594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.

Verify at the official NPI Registry.