Individual provider Active NPI

Kelsey Nicole Wilson, D.M.D

  • Student in an Organized Health Care Education/Training Program
  • Cincinnati, OH
National Provider Identifier
1629536180
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
234 Goodman St
Cincinnati, OH 45219-2364
Phone
(513) 584-6660
Fax
(513) 584-6661
NPI assigned
Mar 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

234 Goodman St
Cincinnati, OH 45219-2364

Mailing address

231 Albert Sabin Way
Cincinnati, OH 45267-2827
Phone (513) 584-6660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190711001543 OH Order and Referring Only - DentistPractitioner - Dentist 1759616832

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1629536180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 ALBERT SABIN WAY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452672827",
            "telephone_number": "513-584-6660",
            "fax_number": "513-584-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 GOODMAN ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192364",
            "telephone_number": "513-584-6660",
            "fax_number": "513-584-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KELSEY",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-04",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.