Edward Wilson, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

6604A Issued in WY

Practice address

1955 Coffeen Ave
Sheridan, WY 82801-5713

Phone

(307) 672-0773

Fax

(307) 672-2739

NPI assigned

Oct 31, 2006

Last updated

Jul 8, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

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

• Urgent Care of Wyoming Inc.

  dba Gillette Urgent Care

  • Nurse Practitioner
  • Gillette, WY
  • NPI 1609896455
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215475200000",
    "number": "1447336680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 COFFEEN AVE",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828015713",
            "telephone_number": "307-672-0773",
            "fax_number": "307-672-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 COFFEEN AVE",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828015713",
            "telephone_number": "307-672-0773",
            "fax_number": "307-672-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "EDWARD",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2008-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "6604A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119617100",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda Kay Williams, CPHT
• Eric Bradley Williams
• Kimberlee D Williams, FNP
• Mandi Williams, M.S. CCC-SLP
• Willow Creek Counseling Associates, LLC
• Michal Richard Wilson, M.D.
• Traci L Wilson, LAC
• Emily Anne Wimsatt, RN
• Zachary Winkelmann, D.C.
• Terry Carl Winnop, MS PT

• Family Medicine Physician in Sheridan, WY
• Providers in Sheridan, WY by specialty
• Family Medicine Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.