NPIMap

Organization Active NPI

Dr J Brad Wilson & Dr Kim Badell Wilson Inc

  • General Practice Dentistry
  • Jasper, IN
National Provider Identifier
1750576633
Registry record updated Sep 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8244 Issued in IN
Legal business name
DR J BRAD WILSON & DR KIM BADELL WILSON INC
Practice address
288 Northwood Ave
Jasper, IN 47546-1212
Phone
(812) 482-1855
Fax
(812) 634-6833
NPI assigned
Sep 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2007

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

Authorized official

Name
Dr. J Brad Wilson, DDSNPI 1841417706
Title
Owner
Phone
(812) 482-1855

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 8244 IN Primary

Addresses

Primary practice location

288 Northwood Ave
Jasper, IN 47546-1212

Mailing address

288 Northwood Ave
Jasper, IN 47546-1212
Phone (812) 482-1855

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189641600000",
    "number": "1750576633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 NORTHWOOD AVE",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475461212",
            "telephone_number": "812-482-1855",
            "fax_number": "812-634-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 NORTHWOOD AVE",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475461212",
            "telephone_number": "812-482-1855",
            "fax_number": "812-634-6833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR J BRAD WILSON & DR KIM BADELL WILSON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-13",
        "last_updated": "2007-09-13",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "BRAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-482-1855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "8244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; 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.