Gina Simone Wilson, M.D. ( MEDICAL DOCTO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

40235 Issued in TN

Practice address

340 9TH St
Florence, OR 97439-9470

Phone

(541) 902-1634

Fax

(541) 902-9702

NPI assigned

Sep 2, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: gwilson61110@direct.peacehealth.org

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.

• Womens Generational Care Obstetrics & Gynecology PLLC

  • Specialist
  • Memphis, TN
  • NPI 1275543241
  NPD (past) Authorized official

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457568000000",
    "number": "1679567788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 SE 164TH AVE DEPT 358",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986838004",
            "telephone_number": "541-902-1634",
            "fax_number": "541-902-9702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 9TH ST",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974399470",
            "telephone_number": "541-902-1634",
            "fax_number": "541-902-9702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "GINA",
        "middle_name": "SIMONE",
        "name_prefix": "Dr.",
        "credential": "M.D. ( MEDICAL DOCTO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-02",
        "last_updated": "2016-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "40235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE HEALTH LICENSE",
            "identifier": "40235",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Western Lane Fire and EMS Authority
• Jo Ann Whitney, RPH
• Howard Williams, RPH
• Krisinda Lee Williams, LPC
• Deanna Judith Wilson
• Kathy Wilson, LMT
• Michelle Wilson, LAC
• Jill Wolfe
• Kellen Wood
• Norma Kay C Wood, LCSW

• Obstetrics & Gynecology Physician in Florence, OR
• Providers in Florence, OR by specialty
• Obstetrics & Gynecology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2016; 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.