Individual provider Active NPI

Alec Wilson, MD

  • Internal Medicine Physician
  • Battle Creek, MI
National Provider Identifier
1780064691
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301501183 Issued in MI
Practice address
181 Emmett St W
Battle Creek, MI 49037-2963
Phone
(269) 965-8866
NPI assigned
Jun 5, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301501183 MI
Internal Medicine Physician 207R00000X 4301501183 MI Primary

Addresses

Primary practice location

181 Emmett St W
Battle Creek, MI 49037-2963

Mailing address

5612 Summer Ridge HL Apt F
Kalamazoo, MI 49009-1046

Other practice location 1

1000 Oakland Dr
Kalamazoo, MI 49008-1282
Phone (269) 337-6115

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301501183MIMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1780064691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5612 SUMMER RIDGE HL APT F",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490091046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 EMMETT ST W",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490372963",
            "telephone_number": "269-965-8866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Oakland Dr",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490081282",
            "country_code": "US",
            "telephone_number": "269-337-6115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ALEC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-05",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301501183",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301501183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.