Active NPI
George E Wilkerson, MD
- Neurology Physician
- Sumrall, MS
National Provider Identifier
1689758385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 05507
- Practice address
- 74 Aultman Rd
Sumrall, MS 39482-4026 - Phone
- (601) 270-4478
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 05507 | MS | Primary |
Addresses
Primary practice location
74 Aultman Rd
Sumrall, MS 39482-4026
Mailing address
74 Aultman Rd
Sumrall, MS 39482-4026
Phone (601) 270-4478
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00014453 | Medicaid | MS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05507 | MS | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Mississippi Neurology Group PA | Neurology | 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": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415750400000",
"number": "1689758385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74 AULTMAN RD",
"city": "SUMRALL",
"state": "MS",
"postal_code": "394824026",
"telephone_number": "601-270-4478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74 AULTMAN RD",
"city": "SUMRALL",
"state": "MS",
"postal_code": "394824026",
"telephone_number": "601-270-4478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKERSON",
"first_name": "GEORGE",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2014-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MS",
"license": "05507",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00014453",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sumrall, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.