Jessica Taylor Wilson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

57111 Issued in TN

Practice address

8110 Walnut Run Rd
Cordova, TN 38018-6362

Phone

(901) 757-3535

NPI assigned

Apr 27, 2015

Last updated

Jun 26, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jwilson28022@mlh.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pediatrics East Inc

  • Pediatrics Physician
  • Cordova, TN
  • NPI 1427066695
  NPD (past)

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1225415474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N DUNLAP ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 WALNUT RUN RD",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380186362",
            "telephone_number": "901-757-3535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 Madison Ave",
            "address_2": "Suite 1031",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381033403",
            "country_code": "US",
            "telephone_number": "901-287-6756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JESSICA",
        "middle_name": "TAYLOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-27",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "57111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire Williamson, MD
• Anna Elizabeth Willis, PMHNP-BC
• Dawn Annette Willis, O.T.R.
• Chelsea Wilson
• James Timothy Wilson II, D.C.
• Katherine McLean Wilson, LPC-MHSP
• Kristin Wilson, NP
• Laura K Wilson, DPT
• Mark T Wilson, DPH
• Queen Valencia Wilson

• Pediatrics Physician in Cordova, TN
• Providers in Cordova, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; 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.