Individual provider Active NPI

Jacob Wilson, MD

  • Emergency Medicine Physician
  • Nashville, TN
National Provider Identifier
1780181016
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
60281 Issued in TN
Practice address
1313 21St Avenue, South
703 Oxford House
Nashville, TN 37232-4700
Phone
(615) 936-0087
NPI assigned
Apr 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 60281 TN Primary

Addresses

Primary practice location

1313 21St Avenue, South
703 Oxford House
Nashville, TN 37232-4700

Mailing address

1313 21St Ave, S
703 Oxford House
Nashville, TN 37232-4700
Phone (615) 936-0087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20200902002877 TN Practitioner - Emergency Medicine 7618394818 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Florida College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of TN, PCGroup PAC ID 3173989837, 144 clinicians
Emergency Physicians at Sumner PLLCGroup PAC ID 2062434160, 10 clinicians

Practice addresses (Care Compare)

100 Summit Blvd
Tristar Mt Juliet ER
Mt Juliet, TN 37122-1700
Phone (615) 449-1100

555 Hartsville Pike
Gallatin, TN 37066-2400
Phone (615) 328-8888

Hospital & facility affiliations

  • Highpoint Health-Sumner With Ascension Saint Thoma Hospital, Gallatin, TN, CCN 440003
  • Tristar Summit Medical Center Hospital, Hermitage, TN, CCN 440150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60281TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of TN, PC Emergency Medicine CurrentSince Mar 1, 2025 Accepting new patients
App of Tennessee Ed, PLLC Emergency Medicine CurrentSince Aug 1, 2020 Accepting new patients
Putnam Emergency Physicians, PLLC Emergency Medicine CurrentSince Sep 1, 2024 Accepting new patients
Emergency Physicians at Sumner PLLC CurrentSince Jul 1, 2021 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

555 Hartsville Pike
Gallatin, TN 37066
Phone (615) 328-5067

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

2300 Patterson St
Nashville, TN 37203
Phone (615) 342-1500

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1780181016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 21ST AVE, S",
            "address_2": "703 OXFORD HOUSE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372324700",
            "telephone_number": "615-936-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 21ST AVENUE, SOUTH",
            "address_2": "703 OXFORD HOUSE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372324700",
            "telephone_number": "615-936-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-12",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "60281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.