Individual provider Active NPI

William E Wilson, MD

  • Family Medicine Physician
  • Clay City, IN
National Provider Identifier
1508857764
Registry record updated Oct 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01043986 Issued in IN
Practice address
315 Lankford St
Clay City, IN 47841-1008
Phone
(812) 939-2126
Fax
(812) 939-3414
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01043986 IN Primary

Addresses

Primary practice location

315 Lankford St
Clay City, IN 47841-1008

Mailing address

PO Box 2505
Indianapolis, IN 46206-2505
Phone (812) 238-7783

Other identifiers 2

IdentifierTypeStateIssuer
P00213807OtherINRR MEDICARE
100369360MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20040825000985 IN Practitioner - Family Practice 0143294025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union Hospital IncGroup PAC ID 8426943614, 90 clinicians

Practice addresses (Care Compare)

1530 N 7TH St
Suite 200
Terre Haute, IN 47807-1061
Phone (812) 238-7631

Hospital & facility affiliations

  • Union Hospital Inc Hospital, Terre Haute, IN, CCN 150023

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01043986INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital Inc. Current Accepting new patients
Union Hospital, Inc. Family Medicine Current Accepting new patients
Union Hospital Inc. Family Medicine CurrentSince Oct 20, 2010 Accepting new patients
Union Hospital, Inc. CurrentSince Oct 20, 2010 Accepting new patients
Midwest Medical Management, P.C. Current Accepting new patients

Locations

315 Lankford St
Clay City, IN 47841
Phone (812) 939-2126

1801 N 6th St
Ste 200
Terre Haute, IN 47804
Phone (812) 238-7301

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

1530 N 7th St
Ste 200
Terre Haute, IN 47807
Phone (812) 238-7631

1513 N 6th St
Terre Haute, IN 47807
Phone (812) 238-7631

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287360000000",
    "number": "1508857764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2505",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462062505",
            "telephone_number": "812-238-7783",
            "fax_number": "812-238-4506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 LANKFORD ST",
            "city": "CLAY CITY",
            "state": "IN",
            "postal_code": "478411008",
            "telephone_number": "812-939-2126",
            "fax_number": "812-939-3414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "WILLIAM",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2010-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01043986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00213807",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100369360",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clay City, IN

Sources for this page

Verify at the official NPI Registry.