Individual provider Active NPI

Jill E Wilson, MD

  • Anesthesiology Physician
  • Atlanta, GA
National Provider Identifier
1447361365
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
055922 Issued in GA
Practice address
1001 Johnson Ferry Road NE
Atlanta, GA 30342
Phone
(404) 785-2008
Fax
(404) 785-4496
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 055922 GA Primary

Addresses

Primary practice location

1001 Johnson Ferry Road NE
Atlanta, GA 30342

Mailing address

1001 Johnson Ferry Road NE
Atlanta, GA 30342
Phone (404) 785-2008

Other identifiers 1

IdentifierTypeStateIssuer
744309857MedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jill.wilson@choa.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20050908000244 GA Practitioner - Anesthesiology 6103858329 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Anesthesia Services, LLC CurrentSince Dec 27, 2022 Accepting new patients
Choa Hospital Based, LLC Past Accepting new patients
Arthur M. Blank Hospital, Inc. Past Accepting new patients

Locations

2620 Satellite Blvd
Duluth, GA 30096
Phone (404) 785-8000

5445 Meridian Mark Rd
Ste 340
Sandy Springs, GA 30342
Phone (404) 785-5650

1001 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 785-2008

Interoperability endpoints

  • Direct secure messaging: jwilson9479@choa.gadirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1447361365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 JOHNSON FERRY ROAD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "404-785-2008",
            "fax_number": "404-785-4496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 JOHNSON FERRY ROAD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "404-785-2008",
            "fax_number": "404-785-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JILL",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "055922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "744309857",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jill.wilson@choa.org",
            "affiliation": "N",
            "address_1": "1001 Johnson Ferry Road NE",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.