Active NPI
Jake Barrett Wilson
- Gastroenterology Physician
- Charleston, SC
National Provider Identifier
1245792357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 88451
- Practice address
- 171 Ashley Ave
Charleston, SC 29425-0100 - Phone
- (843) 792-1414
- NPI assigned
- Apr 5, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 88451 | SC | Primary |
Addresses
Primary practice location
171 Ashley Ave
Charleston, SC 29425-0100
Mailing address
PO Box 751461
Charlotte, NC 28275-1461
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | direct@direct.musc.edu | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6201 Harry Hines Blvd Stop
Suite 9201
Dallas, TX 75390-9201
Phone (214) 645-8300
Hospital & facility affiliations
- Ut of Texas Southwestern University Hospital - William P. Clements Jr.
- Parkland Health & Hospital System
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| V9999 | TX | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The University of Texas Southwestern Medical Center at Dallas | Current | Accepting new patients | |
| University of Texas Southwestern Medical Center at Dallas | Current | Accepting new patients | |
| University of Texas Southwestern Medical Center at Dallas | Current | Accepting new patients |
Locations
2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563
6201 Harry Hines Blvd
Stop 9201
Dallas, TX 75235
6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700
5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390
Organizations & group practices 3
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.
-
- Anesthesiology Physician
- Dallas, TX
- NPI 1942270566
-
- Clinical Medical Laboratory
- Dallas, TX
- NPI 1396832713
-
- Internal Medicine Physician
- Dallas, TX
- NPI 1760452767
Hospital & facility affiliations 46
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Ambulatory Family Planning Facility
- Dallas, TX
- NPI 1144397324
Hospital
-
- Sleep Disorder Diagnostic Clinic/Center
- Dallas, TX
- NPI 1164042784
Hospital
-
- Internal Medicine Physician
- Grand Prairie, TX
- NPI 1194090001
Hospital
-
- Ambulatory Family Planning Facility
- Dallas, TX
- NPI 1235206418
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783641600000",
"number": "1245792357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751461",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "171 ASHLEY AVE",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294250100",
"telephone_number": "843-792-1414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JAKE",
"middle_name": "BARRETT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-05",
"last_updated": "2026-07-10",
"certification_date": "2026-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "SC",
"license": "88451",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "direct@direct.musc.edu",
"affiliation": "N",
"endpointDescription": "SKIP",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "SKIP",
"address_1": "171 Ashley Ave",
"city": "Charleston",
"state": "SC",
"country_code": "US",
"postal_code": "294250100",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.