Mark D Wilson, MD Inc

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

A76869 Issued in CA

Legal business name

MARK D WILSON, MD INC

Practice address

400 W Pueblo St
Santa Barbara, CA 93105-4353

Phone

(805) 682-7111

NPI assigned

Jun 13, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Mark Daniel Wilson, MDNPI 1902819782

Title

President

Phone

(805) 637-1120

Specialties & licenses 1

Addresses

Other names 1

• Mark D Wilson, MD Inc Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark D Wilson, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Santa Barbara, CA
  • NPI 1902819782
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528848000000",
    "number": "1710470703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 LA BUENA TIERRA",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931111705",
            "telephone_number": "805-637-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W PUEBLO ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931054353",
            "telephone_number": "805-682-7111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "351 S Patterson Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Barbara",
            "state": "CA",
            "postal_code": "931112403",
            "country_code": "US",
            "telephone_number": "805-682-7111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARK D WILSON, MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-13",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-637-1120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A76869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mark D Wilson, MD Inc",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Mark D Wilson, MD Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Endocrinology, Diabetes & Metabolism Physician in Santa Barbara, CA
• Providers in Santa Barbara, CA by specialty
• Endocrinology, Diabetes & Metabolism Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.