Robert Clyde Wilson III, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401412457 Issued in VA

Practice address

437 S Magnolia Ave
Waynesboro, VA 22980-3607

Phone

(540) 943-7077

Fax

(540) 943-7505

NPI assigned

Jun 15, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245024000000",
    "number": "1366679631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6759 WELL HOLLOW RD",
            "city": "SINGERS GLEN",
            "state": "VA",
            "postal_code": "228502524",
            "telephone_number": "540-833-4036",
            "fax_number": "540-943-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 S MAGNOLIA AVE",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229803607",
            "telephone_number": "540-943-7077",
            "fax_number": "540-943-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ROBERT",
        "middle_name": "CLYDE",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-15",
        "last_updated": "2009-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401412457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa M. Weaber, LPC
• Michelle Laren Weeks, DVM
• Paula Tai May White
• Erica Wilson, MED, LCMHCA
• Heather Anne Wilson, M.ED., CCC-SLP
• Lynne McElroy Wold, CFNP
• Wonderley Counseling Services
• Rebecca Yvonne Wonderley, LPC, NCC
• Christine Louise Wood, PT, DPT, LMT
• Aliette Elizabeth Wright, P.T.

• General Practice Dentistry in Waynesboro, VA
• Providers in Waynesboro, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2009; 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.