Individual provider Active NPI

Jamison L Wilson, M.D.

  • Vascular & Interventional Radiology Physician
  • Muncie, IN
National Provider Identifier
1427260124
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
01063480A Issued in IN
Practice address
2401 W University Ave
Muncie, IN 47303-3499
Phone
(765) 747-4374
NPI assigned
May 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 01063480A IN
Vascular & Interventional Radiology Physician 2085R0204X 01063480A IN Primary

Addresses

Primary practice location

2401 W University Ave
Muncie, IN 47303-3499

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other identifiers 2

IdentifierTypeStateIssuer
P00966894OtherINRAILROAD MEDICARE
200858000MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwilso23@direct.iuhealth.org

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070828001044 IN Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 7315039872 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Indiana University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indiana University Radiology Associates IncGroup PAC ID 7315922267, 213 clinicians
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

10212 Lantern Rd
Fishers, IN 46037-9705
Phone (317) 841-5656

1111 Ronald Reagan Pkwy
Avon, IN 46123-7085
Phone (317) 963-0166

11725 N Illinois St
Suite 275
Carmel, IN 46032-4656
Phone (317) 817-1114

13000 E 136TH St
Fishers, IN 46037-9478
Phone (317) 678-1700

13100 E 136TH St
Fishers, IN 46037-9417
Phone (317) 963-7757

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

2401 W University Ave
Muncie, IN 47303-3428
Phone (765) 747-4274

2598 W White River Blvd
The Imaging Center
Muncie, IN 47303-5251
Phone (765) 282-7595

2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-9356

416 E Maumee St
Angola, IN 46703-2015
Phone (260) 667-5548

500 S Landmark Ave
Bloomington, IN 47403-3239
Phone (812) 333-7676

500 W Votaw St
Portland, IN 47371-1322
Phone (260) 726-1821

550 N University Blvd Room
Suite 0663
Indianapolis, IN 46202-5149

550 S Landmark Ave
Bloomington, IN 47403-3239
Phone (812) 353-2108

550 University Blvd
Indianapolis, IN 46202-5149
Phone (317) 948-7569

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01063480AINMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Radiology Associates, Inc. Diagnostic Radiology CurrentSince Jul 1, 2011 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Oct 1, 2025 Accepting new patients
Southside Emergency Associates Past Accepting new patients

Locations

5924 Reliable Pkwy
Chicago, IL 60686

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

1701 Senate Blvd
#C6
Indianapolis, IN 46202
Phone (317) 962-9000

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111

Interoperability endpoints

  • Direct secure messaging: jwilson@yourcarecommunity.org
  • Direct secure messaging: jwilso23@direct.iuhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1427260124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W UNIVERSITY AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473033499",
            "telephone_number": "765-747-4374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JAMISON",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01063480A",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IN",
            "license": "01063480A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00966894",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200858000",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwilso23@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "2401 W University Ave",
            "city": "Muncie",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473033499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

Verify at the official NPI Registry.