Craig John Robinson Wilder, ATC

Primary specialty

Sports Medicine (Preventive Medicine) PhysicianTaxonomy code 2083S0010X

License

AL3317 Issued in FL

Practice address

777 Glades Rd
Boca Raton, FL 33431-6496

Phone

(561) 297-2044

Fax

(561) 297-0468

NPI assigned

Mar 23, 2020

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1548896434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 GLADES RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316496",
            "telephone_number": "561-297-2044",
            "fax_number": "561-297-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 GLADES RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316496",
            "telephone_number": "561-297-2044",
            "fax_number": "561-297-0468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "CRAIG",
        "middle_name": "JOHN ROBINSON",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083S0010X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": "FL",
            "license": "AL3317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norman Wiesenthal, M.D.
• Sarah Wiggill, M.D.
• Dawn Wiggins, M.ED., ED.S., LMFT
• Elizabeth Henderika Wiggins, OTRL
• Rhonda Fay Wilcox, PHARM D
• Diana Marcela Wile, LMFT
• Jennifer Bassoff Wilens, LCSW
• Yeva Wilford, CCC-SLP
• Ella Dovrat Wilk, PSYD LMHC
• Margaret R Wilkes, MD

• Sports Medicine (Preventive Medicine) Physician in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Sports Medicine (Preventive Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.