Individual provider Active NPI

Janet Wilson

  • Licensed Practical Nurse
  • Fort Gordon, GA
National Provider Identifier
1740454651
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN068367 Issued in GA
Practice address
300 Hospital Road
Eisenhower Army Medical Center
Ft. Gordon, GA 30905-5650
Phone
(706) 787-2720
NPI assigned
Apr 22, 2008
Last updated
May 14, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN068367 GA Primary

Addresses

Primary practice location

300 Hospital Road
Eisenhower Army Medical Center
Ft. Gordon, GA 30905-5650

Mailing address

300 Hospital Road
Eisenhower Army Medical Center
Ft. Gordon, GA 30905-5650

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN068367GAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1740454651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HOSPITAL ROAD",
            "address_2": "EISENHOWER ARMY MEDICAL CENTER",
            "city": "FT. GORDON",
            "state": "GA",
            "postal_code": "309055650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HOSPITAL ROAD",
            "address_2": "EISENHOWER ARMY MEDICAL CENTER",
            "city": "FT. GORDON",
            "state": "GA",
            "postal_code": "309055650",
            "telephone_number": "706-787-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JANET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN068367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gordon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.