Jonathan K Wilson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2000 Medical Pkwy Ste 101
Annapolis, MD 21401-3743

Phone

(410) 268-0380

NPI assigned

Oct 15, 2018

Reactivated

Nov 2, 2019

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

Enrolled in DC, MD2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwilson104463@direct.aahs.org

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.

• Luminis Health Medical Group, LLC

  dba Ortho and Sports Medicine Center

  • Orthopaedic Surgery Physician
  • Annapolis, MD
  • NPI 1780824615
  Medicare reassignment NPD
• Luminis Health Medical Group, LLC

  dba Luminis Health Maternal and Fetal Medicine

  • Maternal & Fetal Medicine Physician
  • Annapolis, MD
  • NPI 1073580205
  Medicare reassignment
• Luminis Health Medical Group, LLC

  dba Annapolis Surgical Oncology Associates

  • Surgery Physician
  • Annapolis, MD
  • NPI 1649248485

  DC

  Medicare reassignment
• Luminis Health Medical Group, LLC

  dba AAMG Neuropsychology Specialists

  • Clinical Neuropsychologist
  • Annapolis, MD
  • NPI 1114372497
  NPD
• Luminis Health Medical Group, LLC

  dba Anne Arundel Medical Group-Neurology Specialists

  • Neurology Physician
  • Annapolis, MD
  • NPI 1467767806
  NPD
• Luminis Health Medical Group, LLC

  dba LH Primary Care North Hanson

  • Internal Medicine Physician
  • Bowie, MD
  • NPI 1720835010
  NPD

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1619443884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 MEDICAL PKWY STE 101",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MEDICAL PKWY STE 101",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013743",
            "telephone_number": "410-268-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JONATHAN",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-15",
        "last_updated": "2019-11-05",
        "deactivation_date": "2019-04-07",
        "reactivation_date": "2019-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Treva Willis
• Abigail R Wilson
• Dewaynia Wilson, DAC
• Eleanor Wilson
• Jennifer Jane Wilson, LCPC
• Margaret Banks Wilson, FNP-C
• Michelle J Wilson, RPT
• Sue Ellen Wilson, OTR/L
• Hailee Winand
• Rebecca N Winans

• Physician Assistant in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; 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.