Jonathan Corbin Wilton, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD60866075 Issued in WA

Practice address

90 SE Klah Che Min Dr
Shelton, WA 98584-9216

Phone

(360) 427-9006

Fax

(360) 427-1951

NPI assigned

Jun 19, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Texas Tech University Health Science Center School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Squaxin Island TribeGroup PAC ID 2860383122, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwilton606292@wm.providencedirect.org

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.

• Squaxin Island Tribe

  • Clinic/Center
  • Shelton, WA
  • NPI 1669532578
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1316329980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2161 PALISADE BLVD",
            "city": "DUPONT",
            "state": "WA",
            "postal_code": "983279757",
            "telephone_number": "102-792-1537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 SE KLAH CHE MIN DR",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985849216",
            "telephone_number": "360-427-9006",
            "fax_number": "360-427-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILTON",
        "first_name": "JONATHAN",
        "middle_name": "CORBIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-19",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60866075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Owen Wilder
• Michelle Louise Wiley, RDH
• William J Busacca DDS, PS
• Faith Williams, CD
• Jeff Wilson, CDP
• Haley Kai Wood
• Morgan Wood
• Phil Woodard, PHARM.D
• Cheryl Woods, PT
• Philip Matthew Woods, D.P.M

• Family Medicine Physician in Shelton, WA
• Providers in Shelton, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; 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.

Verify at the official NPI Registry.