Individual provider Active NPI

Donald B Wilmes, PHD

  • Psychologist
  • Baltimore, MD
National Provider Identifier
1780717314
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1259 Issued in MD
Practice address
711 W 40TH St
Suite 456a
Baltimore, MD 21211-2199
Phone
(410) 467-1585
Fax
(410) 235-9339
NPI assigned
Mar 13, 2007
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
Psychologist 103T00000X 1259 MD Primary

Addresses

Primary practice location

711 W 40TH St
Suite 456a
Baltimore, MD 21211-2199

Mailing address

711 W 40TH St
Suite 456a
Baltimore, MD 21211-2199
Phone (410) 467-1585

Other identifiers 2

IdentifierTypeStateIssuer
29664OtherMDHOPKINS EMPLOYEE HEALTH P
GL01DBOtherMDCARE 1ST BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Oct 1, 2012 through Oct 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1259MDMDPsychologist
01259MDMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780717314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 W 40TH ST",
            "address_2": "SUITE 456A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112199",
            "telephone_number": "410-467-1585",
            "fax_number": "410-235-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W 40TH ST",
            "address_2": "SUITE 456A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112199",
            "telephone_number": "410-467-1585",
            "fax_number": "410-235-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILMES",
        "first_name": "DONALD",
        "middle_name": "B",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "1259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOPKINS EMPLOYEE HEALTH P",
            "identifier": "29664",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE 1ST BCBS",
            "identifier": "GL01DB",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.