Ian J Wilson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35045266 Issued in OH

Practice address

625 Africa Rd Ste 200
Westerville, OH 43082

Phone

(614) 891-8080

Fax

(614) 891-7078

NPI assigned

Aug 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Central Ohio Primary Care Physicians, Inc.

  • Internal Medicine Physician
  • Westerville, OH
  • NPI 1194705194
  Medicare reassignment
• Westerville Internal Medicine LLC

  • Internal Medicine Physician
  • Westerville, OH
  • NPI 1649386194
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1760598239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 AFRICA RD STE 200",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430829808",
            "telephone_number": "614-891-8080",
            "fax_number": "614-891-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 AFRICA RD STE 200",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "43082",
            "telephone_number": "614-891-8080",
            "fax_number": "614-891-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "IAN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35045266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0467632",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Willow Womens Health LLC
• William A. Wilmer, M.D.
• Alexis Wilson-Glenn, LMT
• Heather Wilson, RPH, PHARMD
• Heather Wilson
• Jennifer Wilson, CLC
• Maranda Wilson, LISW
• Olivia Wilson, PTA
• Taylor Wilson, RBT
• Chadwick Anselm Wilt, PC

• Internal Medicine Physician in Westerville, OH
• Providers in Westerville, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.