Active NPI
Mark E Wilson, M.D.
- Anesthesiology Physician
- Lafayette, CO
National Provider Identifier
1437293222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 27001
- Practice address
- 280 Exempla Cir
Lafayette, CO 80026-3370 - Phone
- (303) 861-3451
- NPI assigned
- Feb 16, 2007
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 27001 | CO | Primary |
Addresses
Primary practice location
280 Exempla Cir
Lafayette, CO 80026-3370
Mailing address
10350 E Dakota Ave
Denver, CO 80247-1314
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004370 | Other | KAISER-COMMERCIAL NUMBER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27001 | CO | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193702400000",
"number": "1437293222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10350 E DAKOTA AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802471314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "280 EXEMPLA CIR",
"city": "LAFAYETTE",
"state": "CO",
"postal_code": "800263370",
"telephone_number": "303-861-3451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MARK",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-16",
"last_updated": "2007-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CO",
"license": "27001",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER-COMMERCIAL NUMBER",
"identifier": "004370",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.