Peter J Wilson, D.C.

Primary specialty

Internist ChiropractorTaxonomy code 111NI0900X

License

2120 Issued in GA

Practice address

1415 Barclay Cir SE
Marietta, GA 30060-2943

Phone

(770) 426-2786

Fax

(770) 792-6113

NPI assigned

Mar 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: pete.wilson.p1@direct.life.nextgenshare.com

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1326178294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 LOVINGGOOD CT",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301897410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 BARCLAY CIR SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300602943",
            "telephone_number": "770-426-2786",
            "fax_number": "770-792-6113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1269 Barclay Cir SE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300602903",
            "country_code": "US",
            "telephone_number": "770-792-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "PETER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR0002120",
            "primary": false
        },
        {
            "code": "111NI0900X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Internist",
            "state": "GA",
            "license": "2120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Wesley Wilson Jr., PSY.D.
• Karlie P Wilson, CCC-SLP
• Katelyn Stahl Wilson, CAA
• Natalee Wilson, MD
• Patrick Wilson, LPC
• Ronald E. Wilson, D.D.S.
• Sara Elizabeth Wilson, AUD
• Skyler Wilson, RBT
• Stephen B Wilson, DMD
• Trina Renee' Wilson, PHD, M.DIV, LCSW

• Internist Chiropractor in Marietta, GA
• Providers in Marietta, GA by specialty
• Internist Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; 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.