Bruce Wilson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

3018 Old Minden Rd Ste 1117
Bossier City, LA 71112-2497

Phone

(318) 746-1935

NPI assigned

May 4, 2023

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Unlimited Alternatives to Change, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bossier City, LA
  • NPI 1053731232
  NPD (past)

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1386333425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3018 OLD MINDEN RD STE 1117",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711122497",
            "telephone_number": "318-746-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3018 OLD MINDEN RD STE 1117",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711122497",
            "telephone_number": "318-746-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRUCE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-04",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willis-Knighton Medical Center, Inc. (Bossier Ear Nose and Throat)
• Willis-Knighton Medical Center, Inc. (North Bossier Internal Medicine)
• Lindsey Willis, RBT
• Regina Renee Willis, N.P.
• Willow Chute Medical, LLC
• Christopher M. Wilson, MD
• Clint N. Wilson, M.D.
• Dorothy Wilson
• Jeannie Wilson
• Michael Wilson

• Case Manager/Care Coordinator in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.