Individual provider Active NPI

James Courtney Wilson, MD

  • Family Medicine Physician
  • Mount Juliet, TN
National Provider Identifier
1629698246
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
68124 Issued in TN
Practice address
325 Old Pleasant Grove Rd
Mount Juliet, TN 37122-4493
Phone
(629) 255-2494
Fax
(629) 255-4264
NPI assigned
Apr 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 68124 TN Primary

Addresses

Primary practice location

325 Old Pleasant Grove Rd
Mount Juliet, TN 37122-4493

Mailing address

222 22ND Ave N
Nashville, TN 37203-1852
Phone (629) 255-3486

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20230801002393 TN Practitioner - Family Practice 9739540170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heritage Medical Associates PCGroup PAC ID 4688651037, 162 clinicians

Practice addresses (Care Compare)

222 22ND Ave N
Nashville, TN 37203-1852
Phone (629) 255-3486

325 Old Pleasant Grove Rd
Mount Juliet, TN 37122-4493
Phone (629) 255-3486

Hospital & facility affiliations

  • Tristar Summit Medical Center Hospital, Hermitage, TN, CCN 440150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
68124TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Medical Associates PC CurrentSince Sep 1, 2023 Accepting new patients
Heritage Medical Associates PC Family Medicine CurrentSince Sep 1, 2023 Accepting new patients

Locations

325 Old Pleasant Grove Rd
Mt Juliet, TN 37122
Phone (629) 255-3486

222 22nd Ave N
Nashville, TN 37203
Phone (629) 255-2620

Interoperability endpoints

  • Direct secure messaging: jameswilson@hma.allscriptsdirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1629698246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 22ND AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031852",
            "telephone_number": "629-255-3486",
            "fax_number": "629-255-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 OLD PLEASANT GROVE RD",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371224493",
            "telephone_number": "629-255-2494",
            "fax_number": "629-255-4264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JAMES",
        "middle_name": "COURTNEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-23",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "68124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Juliet, TN

Sources for this page

Verify at the official NPI Registry.