John Wilson III, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

25MA10496700 Issued in NJ

Practice address

212 W Route 38 Ste 105
Moorestown, NJ 08057-4100

Phone

(856) 600-4011

NPI assigned

Apr 8, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Psychiatry

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Star Community Support ServicesGroup PAC ID 3678082286, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Star Community Support Services

  • Community/Behavioral Health Agency
  • Media, PA
  • NPI 1245947969
  Medicare reassignment Care Compare group NPD
• JGW3 Medical PLLC

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1235874033
  NPD Authorized official
• Star Community Support Services

  • Community/Behavioral Health Agency
  • Norristown, PA
  • NPI 1487361895
  NPD

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1760878599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 W ROUTE 38 STE 105",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080574100",
            "telephone_number": "856-600-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W ROUTE 38 STE 105",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080574100",
            "telephone_number": "856-600-4011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1322 Esplanade Ave",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701161864",
            "country_code": "US",
            "telephone_number": "856-906-4819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-08",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "309405",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA10496700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy R Wexler, M.D.
• Whidbey Island Public Hospital District
• Jayme N White, PA-C
• Donna Graziano Wilcox, D.O.
• Matthew J. Willenkin, MD
• Margaret Wilson
• Brandon Scott Wilton
• Heidi R. Wimberg, MA, LPC
• Kimberly M Winiarczyk, PA
• Andrew Winkler

• Psychiatry Physician in Moorestown, NJ
• Providers in Moorestown, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.
• 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.