Individual provider Active NPI

Louie C. Wilson, M.D.

  • General Practice Physician
  • Mobile, AL
National Provider Identifier
1780619247
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
4211 Issued in AL
Practice address
1855 Spring Hill Ave
Mobile, AL 36607-2301
Phone
(251) 471-3544
Fax
(251) 476-7254
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 4211 AL Primary

Addresses

Primary practice location

1855 Spring Hill Ave
Mobile, AL 36607-2301

Mailing address

1855 Spring Hill Ave
Mobile, AL 36607-2301
Phone (251) 471-3544

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4211ALMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Imc-Cardio-Thoracic and Vascular Surgical Associates LLC PastSince Sep 1, 2019 Accepting new patients
Cardio-Thoracic & Vascular Surgical Associates, P.C. PastSince Oct 17, 2014 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780619247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 SPRING HILL AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366072301",
            "telephone_number": "251-471-3544",
            "fax_number": "251-476-7254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 SPRING HILL AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366072301",
            "telephone_number": "251-471-3544",
            "fax_number": "251-476-7254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LOUIE",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AL",
            "license": "4211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.