Individual provider Active NPI

Ronald Thomas Wilson, M.D.

  • Public Health & General Preventive Medicine Physician
  • Denton, TX
National Provider Identifier
1528096815
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
F6173 Issued in TX
Practice address
2548 Lillian Miller Pkwy
Suite 110
Denton, TX 76210-7212
Phone
(940) 383-5963
Fax
(940) 382-3330
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X F6173 TX Primary

Addresses

Primary practice location

2548 Lillian Miller Pkwy
Suite 110
Denton, TX 76210-7212

Mailing address

2548 Lillian Miller Pkwy
Suite 110
Denton, TX 76210-7212
Phone (940) 383-5963

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140902000503 TX Order and Referring Only - Family PracticePractitioner - Family Practice 6901832369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1528096815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2548 LILLIAN MILLER PKWY",
            "address_2": "SUITE 110",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762107212",
            "telephone_number": "940-383-5963",
            "fax_number": "940-382-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2548 LILLIAN MILLER PKWY",
            "address_2": "SUITE 110",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762107212",
            "telephone_number": "940-383-5963",
            "fax_number": "940-382-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "RONALD",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "TX",
            "license": "F6173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

Verify at the official NPI Registry.