Individual provider Active NPI

Dennis Brian Wilson, RPH

  • Pharmacist
  • Memphis, TN
National Provider Identifier
1649399296
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10011 Issued in TN
Practice address
2525 Horizon Lake Dr
Suite 101
Memphis, TN 38133-8119
Phone
(901) 248-3700
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10011 TN Primary
Pharmacist 183500000X 12367 NE
Pharmacist 183500000X 13200 KY
Pharmacist 183500000X PS39905 FL
Pharmacist 183500000X 17598 LA
Pharmacist 183500000X 13393 AZ
Pharmacist 183500000X 5302034259 MI
Pharmacist 183500000X PD09341 AR
Pharmacist 183500000X E-8250 MS

Addresses

Primary practice location

2525 Horizon Lake Dr
Suite 101
Memphis, TN 38133-8119

Mailing address

3106 Steeplegate Dr
Germantown, TN 38138-7717
Phone (901) 248-3701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PD09341ARMDPharmacist
13393AZMDPharmacist
PS39905FLMDPharmacist
13200KYMDPharmacist
17598LAMDPharmacist
5302034259MIMDPharmacist
E-8250MSMDPharmacist
12367NEMDPharmacist
10011TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dragonfly Health RX, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649399296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3106 STEEPLEGATE DR",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381387717",
            "telephone_number": "901-248-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 HORIZON LAKE DR",
            "address_2": "SUITE 101",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381338119",
            "telephone_number": "901-248-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DENNIS",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "10011",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "12367",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "13200",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS39905",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "17598",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "13393",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302034259",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD09341",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E-8250",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.