Active NPI
Clara Wilson
- Nephrology Physician
- Philadelphia, PA
National Provider Identifier
1740868058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- MD493698
- Practice address
- 3400 Spruce St
Philadelphia, PA 19104-4238 - Phone
- (267) 588-5961
- NPI assigned
- Mar 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | MD493698 | PA | Primary |
| Internal Medicine Physician | 207R00000X | MT232523 | PA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Nephrology Physician | 207RN0300X | MT232523 | PA |
Addresses
Primary practice location
3400 Spruce St
Philadelphia, PA 19104-4238
Mailing address
3400 Spruce St
Philadelphia, PA 19104-4238
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3400 Spruce St
Philadelphia, PA 19104-4226
PO Box
Philadelphia, PA 19182
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD493698 | PA | MD | Nephrology Physician |
| MT232523 | PA | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776297600000",
"number": "1740868058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 SPRUCE ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 SPRUCE ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044238",
"telephone_number": "267-588-5961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CLARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-30",
"last_updated": "2026-04-16",
"certification_date": "2026-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "PA",
"license": "MD493698",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MT232523",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "PA",
"license": "MT232523",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.