Active NPI
Anthony Wilson, M.D.
- Physical Medicine & Rehabilitation Physician
- Muskegon, MI
National Provider Identifier
1427012178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 4301051068
- Practice address
- 1400 Mercy Dr.
Suite 100
Muskegon, MI 49444-1878 - Phone
- (231) 733-1326
- Fax
- (231) 733-5212
- NPI assigned
- Apr 12, 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 |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 4301051068 | MI | Primary |
Addresses
Primary practice location
1400 Mercy Dr.
Suite 100
Muskegon, MI 49444-1878
Mailing address
1400 Mercy Dr.
Suite 100
Muskegon, MI 49444-1878
Phone (231) 830-2727
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2808010 | Medicaid | MI | |
| 4301051068 | Other | MI | STATE LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351728000000",
"number": "1427012178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 MERCY DR.",
"address_2": "SUITE 100",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494441878",
"telephone_number": "231-830-2727",
"fax_number": "231-830-2764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 MERCY DR.",
"address_2": "SUITE 100",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494441878",
"telephone_number": "231-733-1326",
"fax_number": "231-733-5212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ANTHONY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-12",
"last_updated": "2012-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "MI",
"license": "4301051068",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2808010",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "4301051068",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muskegon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.