Active NPI
Daniel Zachary Wilkinson, PH.D.
- Clinical Psychologist
- Saint Louis, MO
National Provider Identifier
1386713477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2006016157
- Practice address
- 1 Jefferson Barracks Dr BLDG 55
Saint Louis, MO 63125-4181 - Phone
- (314) 652-4100
- NPI assigned
- Nov 6, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2006016157 | MO | Primary |
Addresses
Primary practice location
1 Jefferson Barracks Dr BLDG 55
Saint Louis, MO 63125-4181
Mailing address
310 W Losey St
Scott Afb, IL 62225-5250
Phone (618) 256-7386
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006016157 | MO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711929600000",
"number": "1386713477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 W LOSEY ST",
"city": "SCOTT AFB",
"state": "IL",
"postal_code": "622255250",
"telephone_number": "618-256-7386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 JEFFERSON BARRACKS DR BLDG 55",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631254181",
"telephone_number": "314-652-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKINSON",
"first_name": "DANIEL",
"middle_name": "ZACHARY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-06",
"last_updated": "2024-04-01",
"certification_date": "2024-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "2006016157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.