Robert Wilson, DC, PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ROBERT WILSON, DC, PLLC

Practice address

132A N Central Ave
Centerville, TN 37033

Phone

(931) 729-4001

Fax

(931) 729-4081

NPI assigned

Dec 7, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Robert E Wilson, DC

Title

Sole Owner

Phone

(931) 729-4001

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Life Source of Centerville Doing business as

Practitioners 2

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

• Scott F Jutte, D.C.

  • Chiropractor
  • Dickson, TN
  • NPI 1639238801
  NPD (past)
• Nicole Marie Westbrook, D.C

  • Chiropractor
  • Coburg, OR
  • NPI 1851752232
  NPD (past)

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

{
    "created_epoch": "1512604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528675200000",
    "number": "1366957656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "CENTERVILLE",
            "state": "TN",
            "postal_code": "370330099",
            "telephone_number": "931-729-4001",
            "fax_number": "931-729-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132A N CENTRAL AVE",
            "city": "CENTERVILLE",
            "state": "TN",
            "postal_code": "37033",
            "telephone_number": "931-729-4001",
            "fax_number": "931-729-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT WILSON, DC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-07",
        "last_updated": "2018-06-11",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "931-729-4001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIED OF TENNESSEE",
            "identifier": "6128617",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES - INDIVIDUAL NPI",
            "identifier": "1144589458",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Source of Centerville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberley Michelle Primm, R.N.
• Robert Carl Reeves, APRN-BC
• Regina J Elkins OD LLC
• Regina J. Elkins, O.D.
• Reins Recovery Center
• Andy Allen Ross, DPT
• Saint Thomas Health
• Saint Thomas Hickman Hospital
• Saint Thomas Hickman Hospital
• Saint Thomas Hickman Hospital

• All providers in Centerville, TN
• Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; 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.