Simon Wilson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1273 W 12600 S Ste 403
Riverton, UT 84065-7111

Phone

(801) 930-0411

NPI assigned

Sep 2, 2020

Last updated

Sep 2, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Four Corners Community Behavioral Health IncGroup PAC ID 2769377415, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Four Corners Community Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Price, UT
  • NPI 1487715330
  Medicare reassignment Care Compare group NPD
• Four Corners Community Behavioral Health Inc

  dba Operation Recovery

  • Methadone Clinic
  • Price, UT
  • NPI 1164048492
  NPD
• Mountain View Family Therapy LLC

  • Clinical Social Worker
  • Riverton, UT
  • NPI 1790266682
  NPD (past)

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1790399145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 E BELMONT AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841114619",
            "telephone_number": "404-713-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1273 W 12600 S STE 403",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657111",
            "telephone_number": "801-930-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SIMON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-02",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Wilson, DO
• Edla Kalu Wilson III
• Kaedee Wilson
• Kimberly Wilson, PHARMD
• Nancy Funk Wilson, MSW-I
• Larry C Wiseman, A.T.,C.
• Nicolet Wiseman
• Monica Child Wonnacott, M.D.
• Carley Wood
• Jordan Wood, DPT

• Clinical Social Worker in Riverton, UT
• Providers in Riverton, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.