Mark Christopher Wilson, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD0000039499 Issued in TN

Practice address

2025 Virginia Ave
Suite a
Connersville, IN 47331-2921

Phone

(615) 585-5941

NPI assigned

Jun 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, TX2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/lauderd-6f671ec9

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.

• Apogee Medical Group Tennessee PC

  • General Practice Physician
  • Scottsdale, AZ
  • NPI 1578717682

  Internal Medicine, TN

  Medicare reassignment NPD
• Department of Health & Human Services PHS IHS

  • Critical Access Hospital
  • Cass Lake, MN
  • NPI 1194754382

  TX

  Medicare reassignment NPD
• Lauderdale Community Hospital LLC

  dba Lauderdale Community Hospital

  • Critical Access Hospital
  • Ripley, TN
  • NPI 1376175687
  Medicare reassignment NPD
• Lauderdale Community Hospital LLC

  dba Lauderdale Community Hospital

  • Emergency Care Clinic/Center
  • Ripley, TN
  • NPI 1962034272
  Medicare reassignment NPD
• Concord Medical Group of Texas PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1750790762
  Medicare reassignment
• Concord Medical Group PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1083630610

  TN

  Medicare reassignment
• Lauderdale Community Hospital LLC

  dba Lauderdale Community Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Ripley, TN
  • NPI 1356973663
  NPD
• Chattanooga Hamilton County Hospital Authority

  dba University Hospitalists

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1407034028
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1568402121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2561 KANLOW DR",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133951",
            "telephone_number": "615-941-5204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 VIRGINIA AVE",
            "address_2": "SUITE A",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473312921",
            "telephone_number": "615-585-5941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARK",
        "middle_name": "CHRISTOPHER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD0000039499",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "MD0000039499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medicine Physician in Connersville, IN
• Providers in Connersville, IN by specialty
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.