Mark Wilson, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

13693R Issued in LA

Practice address

1415 Tulane Ave
New Orleans, LA 70112-2600

Phone

(504) 988-2300

Fax

(504) 988-3969

NPI assigned

Dec 20, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• East Louisiana State Hospital

  • Psychiatric Hospital
  • Jackson, LA
  • NPI 1043206543
  Medicare reassignment NPD
• Administrators of the Tulane Education Fund

  • Anatomic Pathology & Clinical Pathology Physician
  • New Orleans, LA
  • NPI 1790354595
  NPD (past)
• Administrators of the Tulane Educational Fund

  • Specialist
  • New Orleans, LA
  • NPI 1528014164
  NPD (past)

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1629132246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 TULANE AVE",
            "address_2": "TW22",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122632",
            "telephone_number": "504-988-2300",
            "fax_number": "504-988-3969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 TULANE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122600",
            "telephone_number": "504-988-2300",
            "fax_number": "504-988-3969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "13693R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1425184",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lacey Wilson
• Lajoy Wilson
• Leatrice Ann Wilson, LCSW-BACS
• Linda Wilson
• Mandy Wilson, LCSW
• Mark Joseph Wilson, CRNA, DNP
• Melanie Moore Wilson, M.D.
• Merlin Robert Wilson Jr., M.D.
• Peter Henican Wilson
• Rhonda Wilson

• Psychiatry Physician in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Psychiatry Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.