Active NPI
Mark Wilson
- Clinic/Center
- Philadelphia, PA
National Provider Identifier
1750736088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- A-6418104
- Practice address
- 5313 Ogden St
Philadelphia, PA 19139-1438 - Phone
- (215) 600-9477
- Fax
- (215) 921-8499
- NPI assigned
- Apr 23, 2016
- Last updated
- Apr 23, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | A-6418104 | PA | Primary |
Addresses
Primary practice location
5313 Ogden St
Philadelphia, PA 19139-1438
Mailing address
5313 Ogden St
Philadelphia, PA 19139-1438
Phone (215) 600-9477
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
| License | State | Type | Specialty |
|---|---|---|---|
| A-6418104 | PA | MD | Clinic/Center |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mwe Transport Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Non-emergency Medical Transport (VAN)
- Philadelphia, PA
- NPI 1831544659
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461369600000",
"number": "1750736088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5313 OGDEN ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191391438",
"telephone_number": "215-600-9477",
"fax_number": "215-921-8499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5313 OGDEN ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191391438",
"telephone_number": "215-600-9477",
"fax_number": "215-921-8499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MARK",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-23",
"last_updated": "2016-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "PA",
"license": "A-6418104",
"primary": true
}
],
"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 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.