Active NPI
Dwayne G Wilson, RP, CDM
- Pharmacist
- Lincoln, NE
National Provider Identifier
1760474357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 7975
- Practice address
- 7524 Karl Dr
Lincoln, NE 68516-4372 - Phone
- (402) 489-2915
- Fax
- (402) 489-3052
- NPI assigned
- Aug 18, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 7975 | NE | Primary |
Addresses
Primary practice location
7524 Karl Dr
Lincoln, NE 68516-4372
Mailing address
7524 Karl Dr
Lincoln, NE 68516-4372
Phone (402) 489-2915
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 |
|---|---|---|---|
| 7975 | NE | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395187200000",
"number": "1760474357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7524 KARL DR",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685164372",
"telephone_number": "402-489-2915",
"fax_number": "402-489-3052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7524 KARL DR",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685164372",
"telephone_number": "402-489-2915",
"fax_number": "402-489-3052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "DWAYNE",
"middle_name": "G",
"credential": "RP, CDM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-18",
"last_updated": "2014-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "7975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.