William Carroll Wilson, PA-C, MMSC.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA0000001053 Issued in TN

Practice address

281 N Lyerly St Ste 200
Chattanooga, TN 37404-2728

Phone

(423) 698-0850

Fax

(423) 698-0511

NPI assigned

Apr 7, 2011

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: wwilson@ss-tn.direct.office.nextgen.com

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.

• Chattanooga Rehabilitation Associates, PC

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  • NPI 1891741971
  NPD (past)
• East Tennessee Neuropathy, PC

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1649511965
  NPD (past)

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

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1497045728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 N LYERLY ST STE 200",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374042728",
            "telephone_number": "423-698-0850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 N LYERLY ST STE 200",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374042728",
            "telephone_number": "423-698-0850",
            "fax_number": "423-698-0511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Stein Dr",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374217217",
            "country_code": "US",
            "telephone_number": "423-648-8480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "WILLIAM",
        "middle_name": "CARROLL",
        "name_prefix": "Mr.",
        "credential": "PA-C, MMSC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-07",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "PA0000001053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael D Wilson, ED.S.
• Misty Wilson, SLP-CCC
• Olivia Kaziah Wilson, NP
• Stephanie Wilson, NURSE PRACTITIONER
• Valerie Faye Wilson, LPN, MX
• Willim Wilson
• Briana Nicole Wimsatt
• Fernando Jose Windemuller, M.D.
• Lesley Anne Wingate Crawford, MSSW
• Katrina Jane Wingertsahn, CF-SLP

• Medical Physician Assistant in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.