Active NPI
Jennifer Wilkinson, M.D.
- Pediatrics Physician
- Missoula, MT
National Provider Identifier
1568808525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MED-PHYS-LIC-49781
- Practice address
- 3075 N Reserve St Ste Q
Missoula, MT 59808-1390 - Phone
- (406) 327-1850
- Fax
- (406) 327-1875
- NPI assigned
- May 17, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | MED-PHYS-LIC-49781 | MT | Primary |
Addresses
Primary practice location
3075 N Reserve St Ste Q
Missoula, MT 59808-1390
Mailing address
PO Box 12
Liberty Lake, WA 99019-0012
Phone (406) 327-1850
Other practice location 1
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-6562
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jwilkinson1379641@wm.providencedirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MED-PHYS-LIC-49781 | MT | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619654400000",
"number": "1568808525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12",
"city": "LIBERTY LAKE",
"state": "WA",
"postal_code": "990190012",
"telephone_number": "406-327-1850",
"fax_number": "406-327-1875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3075 N RESERVE ST STE Q",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598081390",
"telephone_number": "406-327-1850",
"fax_number": "406-327-1875"
}
],
"practiceLocations": [
{
"address_1": "22 Bramhall St",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "ME",
"postal_code": "041023134",
"country_code": "US",
"telephone_number": "207-662-6562",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILKINSON",
"first_name": "JENNIFER",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-17",
"last_updated": "2021-04-29",
"certification_date": "2021-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MT",
"license": "MED-PHYS-LIC-49781",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jwilkinson1379641@wm.providencedirect.org",
"affiliation": "N",
"address_1": "3075 N Reserve St Ste Q",
"city": "Missoula",
"state": "MT",
"country_code": "US",
"postal_code": "598081390",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.