Jacob Wesley Wilson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR008587 Issued in GA

Practice address

2494 Jett Ferry Rd
Suite #103
Dunwoody, GA 30338-3090

Phone

(404) 805-5961

NPI assigned

Dec 9, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wilson Family ChiropracticGroup PAC ID 5890820567, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wilson Family Chiropractic

  • Chiropractor
  • Dunwoody, GA
  • NPI 1417286410
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1260316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260316800000",
    "number": "1730418476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2494 JETT FERRY RD",
            "address_2": "SUITE #103",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303383090",
            "telephone_number": "404-805-5961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2494 JETT FERRY RD",
            "address_2": "SUITE #103",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303383090",
            "telephone_number": "404-805-5961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JACOB",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-09",
        "last_updated": "2009-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devon Nicholas Williams
• Joseph Hillman Williams, PHARM.D.
• Johneria Willis
• Wilson Family Chiropractic
• Charles W Wilson Jr., PHARMACIST
• Katherine Alexia Wilson, DC
• Bree Winkler, LPC, ED.S.
• Melissa Winsor, CRNFA
• Lauren Wishneff, LCSW
• With Love Counseling

• Chiropractor in Dunwoody, GA
• Providers in Dunwoody, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.