James Tyrone Wilder

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13946CP Issued in SC

Practice address

501 Belle Hall Pkwy Unit 102
Mount Pleasant, SC 29464-8322

Phone

(843) 225-0567

NPI assigned

Oct 23, 2017

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

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1346751971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 BELLE HALL PKWY UNIT 102",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294648322",
            "telephone_number": "843-225-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 BELLE HALL PKWY UNIT 102",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294648322",
            "telephone_number": "843-225-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "JAMES",
        "middle_name": "TYRONE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-23",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "12209",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "13946CP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisa G. Whittington, FNP
• Morgan Schweers Widenhouse
• Matthew Wikman
• Kandis G Wilcox, MD
• Michelle Wilcox, PHARMD
• Wildflower Center for Counseling
• Richard Travis Wilkes, M.D.
• Kailey Michele Wilkins, PHARMD
• Mariah Wilkins
• William Christopher Orr

• Clinical Social Worker in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Clinical Social Worker in South Carolina

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