Wendy Meade Wilson, MD

Primary specialty

Clinical & Laboratory Dermatological Immunology PhysicianTaxonomy code 207NI0002X

License

01057248 Issued in IN

Practice address

6820 Parkdale Place
Suite 211
Indianapolis, IN 46254-6600

Phone

(317) 329-7050

Fax

(317) 328-6809

NPI assigned

Oct 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Indiana University School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eagle Creek DermatologyGroup PAC ID 8921131731, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Hospital, Indianapolis, IN, CCN 150056

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Eagle Creek Dermatology

  • Clinical & Laboratory Dermatological Immunology Physician
  • Indianapolis, IN
  • NPI 1053561928
  Medicare reassignment Care Compare group NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indiana University Health Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1144266024
  Care Compare affiliation

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274832000000",
    "number": "1427145986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6820 PARKDALE PLACE",
            "address_2": "SUITE 211",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462546600",
            "telephone_number": "317-329-7050",
            "fax_number": "317-328-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6820 PARKDALE PLACE",
            "address_2": "SUITE 211",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462546600",
            "telephone_number": "317-329-7050",
            "fax_number": "317-328-6809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "WENDY",
        "middle_name": "MEADE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2010-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NI0002X",
            "taxonomy_group": "",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "IN",
            "license": "01057248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200441010",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000279117",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taniqua Wilson
• Tanya Kezia Danielle Wilson, M.D.
• Taylor Linn Wilson, PMHNP-BC
• Twila Elaine Wilson, PSYD
• Vagie L Wilson
• William Luke Wilson
• Yuri Wilson
• Zoe Wilson
• Keri Lynn Wimberly-Brown, MS, LCAC, CADAC IV
• Amy Denise Wimbleduff, AGNP

• Dermatology Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Dermatology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.