Dennis W Wilson PHD PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

DENNIS W WILSON PHD PLLC

Practice address

1020 Ellington Dr
Milan, TN 38358-3150

Phone

(731) 431-0609

NPI assigned

Aug 15, 2007

Organization subpart

No

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

Authorized official

Name

Dennis W Wilson, PHDNPI 1780625202

Title

Owner

Phone

(731) 431-0609

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dennis Wayne Wilson, PHD

  • Clinical Psychologist
  • Milan, TN
  • NPI 1780625202
  Medicare reassignment NPD Authorized official
• Martin Ervin Cleveland, PHD

  • Clinical Psychologist
  • Fort Campbell, KY
  • NPI 1275632242
  NPD (past)

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307577600000",
    "number": "1356533137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 BLACKMON STREET",
            "city": "MEDINA",
            "state": "TN",
            "postal_code": "383556829",
            "telephone_number": "731-431-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 ELLINGTON DR",
            "city": "MILAN",
            "state": "TN",
            "postal_code": "383583150",
            "telephone_number": "731-431-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS W WILSON PHD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-15",
        "last_updated": "2011-06-09",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-431-0609",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36815542",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Hames Cummings, PA-C
• Bethany Anne Davenport, P.T.
• Jean Davis, DO
• Jesse A Dean III, D.C.
• Ashley Lynn Deeter, DC
• Dr Jennifer J Pitts
• DRS. Harrison & Tucker
• Laura Duck
• Dynamix Physical Therapy LLC
• E.W. James & Sons

• Clinical Psychologist in Milan, TN
• Providers in Milan, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.