Chauncey A Wilkins, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

17482 Issued in NE

Practice address

4101 Woolworth Ave
Omaha, NE 68105-1850

Phone

(402) 346-8800

Fax

(402) 943-5575

NPI assigned

Feb 10, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NE

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1316910144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 WOOLWORTH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051850",
            "telephone_number": "402-346-8800",
            "fax_number": "402-943-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 WOOLWORTH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051850",
            "telephone_number": "402-346-8800",
            "fax_number": "402-943-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "CHAUNCEY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "17482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID RHC",
            "identifier": "10025024000",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47042628508",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trevor J Wilke, M.D.
• Mary Ann Wilken, RN,BC
• Steven D Wilkening, M.D.
• Heather Elizabeth Wilkie
• Alvino Wilkins
• Katelynne Wilkins
• Mattie Lee Wilkins
• Rachel Wilkins
• Robin Wilkins
• Samuel J Wilkins, ATC

• Family Medicine Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Family Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.