Active NPI
James M Wilson, MD, PHD
- Clinical Genetics (M.D.) Physician
- Philadelphia, PA
National Provider Identifier
1316979131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Genetics (M.D.) Physician
- License
- MD049539L
- Practice address
- 3400 Spruce St
Philadelphia, PA 19104-4206 - Phone
- (215) 662-6503
- NPI assigned
- Jul 6, 2006
- 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 |
|---|---|---|---|---|
| Clinical Genetics (M.D.) Physician | 207SG0201X | MD049539L | PA | Primary |
Addresses
Primary practice location
3400 Spruce St
Philadelphia, PA 19104-4206
Mailing address
125 S 31St St
Suite 2000 TRL
Philadelphia, PA 19104-3413
Phone (215) 573-9020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001478725 | Medicaid | PA |
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)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD049539L | PA | MD | Clinical Genetics (M.D.) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Pennsylvania | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Philadelphia, PA
- NPI 1164736948
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418256000000",
"number": "1316979131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 S 31ST ST",
"address_2": "SUITE 2000 TRL",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191043413",
"telephone_number": "215-573-9020",
"fax_number": "215-494-5444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 SPRUCE ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044206",
"telephone_number": "215-662-6503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JAMES",
"middle_name": "M",
"credential": "MD, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-06",
"last_updated": "2014-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "207SG0201X",
"taxonomy_group": "",
"desc": "Medical Genetics, Clinical Genetics (M.D.)",
"state": "PA",
"license": "MD049539L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001478725",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.