Jed Wilson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2021 Issued in NH

Practice address

90 Odell Hill Rd
Conway, NH 03818-4401

Phone

(603) 730-9154

Fax

(603) 730-9154

NPI assigned

Jan 16, 2015

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 NH, ME2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Jed Wilson

  • Clinical Social Worker
  • Lovell, ME
  • NPI 1851275838
  NPD (past) Authorized official

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1366831117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 111",
            "city": "CENTER CONWAY",
            "state": "NH",
            "postal_code": "038130111",
            "telephone_number": "603-730-9154",
            "fax_number": "603-730-9154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 ODELL HILL RD",
            "city": "CONWAY",
            "state": "NH",
            "postal_code": "038184401",
            "telephone_number": "603-730-9154",
            "fax_number": "603-730-9154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Main St",
            "address_purpose": "LOCATION",
            "city": "Fryeburg",
            "state": "ME",
            "postal_code": "040371127",
            "country_code": "US",
            "telephone_number": "207-209-4477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-16",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "2021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• White Mountain Community Health Center
• Erin White, CRSW
• Nicholas William White, DA, LCSW, MLADC
• Benjamin Wiggin
• Kristin Wiley
• Michelle Wilson
• Christopher Henry Wong, LCMHC, MSED
• Tamara Wood, LMT
• Danielle Woodbury, WAIVER
• Anisa Woodsum, WAIVERED

• Clinical Social Worker in Conway, NH
• Providers in Conway, NH by specialty
• Clinical Social Worker in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.