Individual provider Active NPI

Julie Clare Wilson, M.D.

  • Pediatric Sports Medicine Physician
  • Aurora, CO
National Provider Identifier
1790807659
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X
License
0052807 Issued in CO
Practice address
13123 E 16TH Ave
Aurora, CO 80045-7106
Phone
(720) 777-1234
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Sports Medicine Physician 2080S0010X 0052807 CO Primary
Sports Medicine (Family Medicine) Physician 207QS0010X 35095723 OH

Addresses

Primary practice location

13123 E 16TH Ave
Aurora, CO 80045-7106

Mailing address

PO Box 110429
Aurora, CO 80042-0429
Phone (303) 493-7000

Other names 1

  • Julie Clare Schreck Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20131014000635 CO Practitioner - Orthopedic SurgeryPractitioner - Sports MedicinePractitioner - Pediatric Medicine 9830367200 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0052807COMDPediatric Sports Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated Sports Medicine CurrentSince Sep 1, 2013 Accepting new patients
University Physicians Incorporated CurrentSince Sep 1, 2013 Accepting new patients
Children'S Hospital Colorado Current Accepting new patients

Locations

860 Potomac Cir
Aurora, CO 80011
Phone (720) 777-0300

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

469 State Highway 7
Broomfield, CO 80023
Phone (720) 478-5000

9094 E Mineral Cir
Ste 110
Centennial, CO 80112
Phone (303) 649-0114

1830 N Franklin St
Denver, CO 80218
Phone (303) 253-7373

Dept 1061
Denver, CO 80256

1811 Plaza Dr
Highlands Ranch, CO 80129
Phone (720) 478-0108

Interoperability endpoints

  • Direct secure messaging: jwilson9810@direct.childrenscolorado.org

Organizations & group practices 3

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1790807659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429",
            "telephone_number": "303-493-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "720-777-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JULIE",
        "middle_name": "CLARE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "CO",
            "license": "0052807",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OH",
            "license": "35095723",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "SCHRECK",
            "middle_name": "CLARE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.