Active NPI
John Elwood Wilson, M.D.
- Anesthesiology Physician
- Des Moines, IA
National Provider Identifier
1255317186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 20335
- Practice address
- 1215 Pleasant St
Suite 400
Des Moines, IA 50309-1416 - Phone
- (515) 241-5722
- Fax
- (515) 241-4403
- NPI assigned
- Dec 22, 2005
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 20335 | IA | Primary |
Addresses
Primary practice location
1215 Pleasant St
Suite 400
Des Moines, IA 50309-1416
Mailing address
1215 Pleasant St Ste 400
Des Moines, IA 50309-1418
Phone (515) 241-5722
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4268 | Other | IA | MIDLANDS PROVIDER # |
| 15095 | Other | IA | BLUE SHIELD PROVIDER # |
| IA0114 | Other | IA | JOHN DEERE PROVIDER # |
| 0150953 | Medicaid | IA | |
| 20335 | Other | IA | TRICARE PROVIDER # |
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 |
|---|---|---|---|
| 20335 | IA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1255317186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1215 PLEASANT ST STE 400",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503091418",
"telephone_number": "515-241-5722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 PLEASANT ST",
"address_2": "SUITE 400",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503091416",
"telephone_number": "515-241-5722",
"fax_number": "515-241-4403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JOHN",
"middle_name": "ELWOOD",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-22",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IA",
"license": "20335",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS PROVIDER #",
"identifier": "4268",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD PROVIDER #",
"identifier": "15095",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE PROVIDER #",
"identifier": "IA0114",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0150953",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE PROVIDER #",
"identifier": "20335",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.