Individual provider Active NPI

John Michael Wilson

  • Neurological Surgery Physician
  • Cape Coral, FL
National Provider Identifier
1639673924
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
ME173577 Issued in FL
Practice address
632 Del Prado Blvd N
Cape Coral, FL 33909-2278
Phone
(239) 343-3800
Fax
(239) 343-4261
NPI assigned
Mar 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 326172 LA
Student in an Organized Health Care Education/Training Program 390200000X
Neurological Surgery Physician 207T00000X ME173577 FL Primary

Addresses

Primary practice location

632 Del Prado Blvd N
Cape Coral, FL 33909-2278

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (393) 433-8002

Other practice location 1

235 Sable Fls
San Antonio, TX 78258-4870
Phone (210) 255-0761

Other identifiers 1

IdentifierTypeStateIssuer
127244600MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwilson673018@Direct.leememorial.org Direct LEE HEALTH SYSTEM INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230120001931 LA Practitioner - General Practice 5193072429 Reassigns benefits to 1 organization
I20250603000552 FL Practitioner - Neurosurgery 5193072429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Texas Tech University Health Science Center School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

632 Del Prado Blvd N
Suite 1
Cape Coral, FL 33909-2278
Phone (239) 772-5577

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion41
Laminectomy or laminotomy (partial removal of spine bones)13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc General Practice CurrentSince Jun 25, 2025 Accepting new patients
Signify Health, LLC General Practice CurrentSince Oct 8, 2022 Accepting new patients
Lee Health System Inc CurrentSince Jun 25, 2025 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

636 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 332-5344

632 Del Prado Blvd N
Ste 1
Cape Coral, FL 33909
Phone (239) 468-8076

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

201 Saint Charles Ave
Ste 2500
New Orleans, LA 70170
Phone (504) 582-1416

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: jwilson673018@direct.leememorial.org

Organizations & group practices 3

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 3

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": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1639673924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "393-433-8002",
            "fax_number": "239-343-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 DEL PRADO BLVD N",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339092278",
            "telephone_number": "239-343-3800",
            "fax_number": "239-343-4261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "235 Sable Fls",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782584870",
            "country_code": "US",
            "telephone_number": "210-255-0761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "LA",
            "license": "326172",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME173577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127244600",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwilson673018@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "LEE HEALTH SYSTEM INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.