Clifford Wilson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5991 Issued in MN

Practice address

6466 Kings Dr
Saint Paul, MN 55128-2523

Phone

(651) 249-4181

NPI assigned

Jan 6, 2015

Sex

Male

Sole proprietor

No

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 MN

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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 P.a.

  • Chiropractor
  • Oakdale, MN
  • NPI 1629469978
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1420502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1750779252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6466 KINGS DR",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551282523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6466 KINGS DR",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551282523",
            "telephone_number": "651-249-4181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CLIFFORD",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-06",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willows of Episcopal Homes LLC
• Laura Elizabeth Willson, PA-C
• Michael L Willson, MD
• Devolia Wilson-Johnson
• Albert Graham Wilson IV, LPC
• Estefania Wilson
• Jamie Irene Wilson, RN
• Jennifer Wilson
• Joseph Samuel Wilson, CRNA
• Joycelyn Ampon Wilson, CRNA

• Chiropractor in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; 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.