Thomas L Wilson, RN

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

579666 Issued in NY

Practice address

255 Gordon St
Staten Island, NY 10304-1943

Phone

(888) 554-3810

Fax

(206) 426-0930

NPI assigned

Nov 20, 2012

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Dr. Donald R Lee-Edwards PH.D, LP

  • Adult Mental Health Clinic/Center
  • Staten Island, NY
  • NPI 1710252127
  NPD (past)

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353456000000",
    "number": "1801130489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 DANIEL LOW TER APT 4K",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103011740",
            "telephone_number": "888-554-3810",
            "fax_number": "206-426-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 GORDON ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103041943",
            "telephone_number": "888-554-3810",
            "fax_number": "206-426-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "THOMAS",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-20",
        "last_updated": "2012-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "NY",
            "license": "579666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David F Wilson, LCSW
• Elizabeth Wilson
• Joseph Wilson
• Marjorie Wilson, N.P
• Michelle M Wilson, PT
• Jennifer Aileen Wilton, RPAC
• Amanda M Winant
• Alexa Layne Winchel, OTR/L
• Lissa Dale Winchel, LCSW
• Neil Winchel

• Case Management Registered Nurse in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Case Management Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; 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.