Individual provider Active NPI

Jane Ellen Wilson, MD

  • Pediatrics Physician
  • Indianapolis, IN
National Provider Identifier
1659375335
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01047151A Issued in IN
Practice address
5550 S East St
Ste.I
Indianapolis, IN 46227-1979
Phone
(317) 780-4080
Fax
(317) 780-4088
NPI assigned
Jun 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 01047151 IN
Pediatrics Physician 208000000X 01047151A IN Primary

Addresses

Primary practice location

5550 S East St
Ste.I
Indianapolis, IN 46227-1979

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone (317) 948-2700

Other identifiers 2

IdentifierTypeStateIssuer
000000507395OtherINANTHEM
200181770MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwilso26@direct.iuhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20070522000376 IN Practitioner - Pediatric Medicine 3173620499 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01047151INMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Care Associates, Inc CurrentSince Aug 20, 2022 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients
University Family Physicians, Inc. CurrentSince Feb 6, 2019 Accepting new patients
University Family Physicians, Inc. CurrentSince Feb 6, 2019 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

7216 Solutions Ctr
Chicago, IL 60677

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

9650 E Washington St
Indianapolis, IN 46229
Phone (317) 890-5500

5550 S East St
Ste 1
Indianapolis, IN 46227
Phone (317) 780-4080

5550 S East St
Ste I
Indianapolis, IN 46227
Phone (317) 780-4080

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

720 Eskenazi Ave
Fl 5
Indianapolis, IN 46202
Phone (317) 880-6000

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

5550 S East St
Indianapolis, IN 46227
Phone (317) 534-4660

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

Interoperability endpoints

  • Direct secure messaging: jwilso26@direct.iuhealth.org

Organizations & group practices 6

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1659375335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 S EAST ST",
            "address_2": "STE.I",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462271979",
            "telephone_number": "317-780-4080",
            "fax_number": "317-780-4088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 Riley Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025109",
            "country_code": "US",
            "telephone_number": "317-948-2700",
            "fax_number": "317-948-2959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JANE",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-09",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IN",
            "license": "01047151",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01047151A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000507395",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200181770",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwilso26@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "5550 S East St",
            "address_2": "Ste.I",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462271979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.