Carl Wilson MD Inc & Jill Edison MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

G44318 Issued in CA

Legal business name

CARL WILSON MD INC & JILL EDISON MD

Practice address

435 Doyle Park Dr
Santa Rosa, CA 95405-4515

Phone

(707) 527-9510

Fax

(707) 527-1306

NPI assigned

Aug 16, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Carl Wilson, MD

Title

Senior Partner

Phone

(707) 527-9510

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291593600000",
    "number": "1255323325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 DOYLE PARK DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054515",
            "telephone_number": "707-527-9510",
            "fax_number": "707-527-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 DOYLE PARK DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054515",
            "telephone_number": "707-527-9510",
            "fax_number": "707-527-1306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL WILSON MD INC & JILL EDISON MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2010-12-06",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "SENIOR PARTNER",
        "authorized_official_telephone_number": "707-527-9510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G44318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lucia Carol Cargill, PHD, MSN, FNP-C
• Caring a Life Home Care Agency
• Carlos Flores Lavenant DDS Inc
• Shawn Maria Carlos
• Dante Carlozzi
• Kim L. Carlson-Sweet, MD
• Charlotte Mary Carlson, M.D.

• Nephrology Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; 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.