Timothy Wilson

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6057 Issued in VA

Practice address

1237 W Divide Ave Ste 5
Bismarck, ND 58501-1208

Phone

(701) 328-8851

NPI assigned

Apr 12, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Central Human Service CenterGroup PAC ID 6002801107, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• West Central Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bismarck, ND
  • NPI 1649226713
  Medicare reassignment Care Compare group NPD
• North Central Behavioral Health Clinic

  • Clinic/Center
  • Minot, ND
  • NPI 1477592533
  Medicare reassignment NPD

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1477133718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 W DIVIDE AVE STE 5",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011208",
            "telephone_number": "701-328-8851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 W DIVIDE AVE STE 5",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011208",
            "telephone_number": "701-328-8851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-12",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "VA",
            "license": "6057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenise Delores Wilson, MS, LPCC
• Jonathan O. Wilson
• Kimberly Wilson, PHARM D
• Kiyanna G Wilson
• Nichole Carol Wilson, RN
• Shawna Wing, MS, OTR/L
• Madison Hope Winkle, LPCC, LAC
• Carol J Winkler, DC
• Kimberly Kate Winters, APRN, CNP
• Sara Winters, APRN

• Social Worker in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.