Active NPI
Dane Norris Wilson, DO
- Family Medicine Physician
- Gothenburg, NE
National Provider Identifier
1386336824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 94-11403
- Practice address
- 910 20TH St
Gothenburg, NE 69138-1237 - Phone
- (308) 550-8810
- NPI assigned
- May 23, 2023
- Last updated
- Aug 25, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 94-11403 | KS | Primary |
Addresses
Primary practice location
910 20TH St
Gothenburg, NE 69138-1237
Mailing address
PO Box 469
Gothenburg, NE 69138-0469
Phone (308) 537-3661
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230724002806 | KS | Order and Referring Only - Family Practice | 8022478973 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787616000000",
"number": "1386336824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 469",
"city": "GOTHENBURG",
"state": "NE",
"postal_code": "691380469",
"telephone_number": "308-537-3661",
"fax_number": "308-537-3074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "910 20TH ST",
"city": "GOTHENBURG",
"state": "NE",
"postal_code": "691381237",
"telephone_number": "308-550-8810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "DANE",
"middle_name": "NORRIS",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-23",
"last_updated": "2026-08-25",
"certification_date": "2026-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "94-11403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gothenburg, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; 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.