Organization Active NPI

Catherine J. Wilson, DPM

  • Podiatrist
  • Las Vegas, NV
National Provider Identifier
1316154883
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0306 Issued in NV
Legal business name
CATHERINE J. WILSON, DPM
Practice address
2660 Crimson Canyon Dr
Suite 130
Las Vegas, NV 89128-0845
Phone
(702) 453-3799
Fax
(702) 453-5741
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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

Authorized official

Name
Catherine J Wilson, DPMNPI 1720179716
Title
Sole Owner
Phone
(702) 326-2077

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 0306 NV Primary

Addresses

Primary practice location

2660 Crimson Canyon Dr
Suite 130
Las Vegas, NV 89128-0845

Mailing address

2660 Crimson Canyon Dr
Suite 130
Las Vegas, NV 89128-0845
Phone (702) 453-3799

Other identifiers 1

IdentifierTypeStateIssuer
1316154883MedicaidNV

National Provider Directory

National Provider Directory

Locations

6000 S Eastern Ave
Ste 7A
Las Vegas, NV 89119
Phone (702) 795-0313

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": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436400000000",
    "number": "1316154883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 CRIMSON CANYON DR",
            "address_2": "SUITE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280845",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 CRIMSON CANYON DR",
            "address_2": "SUITE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280845",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHERINE J. WILSON, DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2015-07-09",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "702-326-2077",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NV",
            "license": "0306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316154883",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; 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.