Active NPI
Matthew Wilson, PHARM.D.
- Critical Care Pharmacist
- Kissimmee, FL
National Provider Identifier
1801163993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Pharmacist
- License
- PS52526
- Practice address
- 700 W Oak St
Kissimmee, FL 34741 - Phone
- (407) 518-4256
- NPI assigned
- Nov 17, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302039491 | MI | |
| Critical Care Pharmacist | 1835C0205X | PS52526 | FL | Primary |
Addresses
Primary practice location
700 W Oak St
Kissimmee, FL 34741
Mailing address
700 W Oak St
Kissimmee, FL 34741-4924
Phone (407) 518-4256
Other practice location 1
44201 Dequindre Rd
Troy, MI 48085-1117
Phone (810) 962-6880
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 Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302039491 | MI | MD | Pharmacist |
| PS52526 | FL | MD | Critical Care Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526947200000",
"number": "1801163993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 W OAK ST",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347414924",
"telephone_number": "407-518-4256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 W OAK ST",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "34741",
"telephone_number": "407-518-4256"
}
],
"practiceLocations": [
{
"address_1": "44201 Dequindre Rd",
"address_purpose": "LOCATION",
"city": "Troy",
"state": "MI",
"postal_code": "480851117",
"country_code": "US",
"telephone_number": "810-962-6880",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-17",
"last_updated": "2018-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302039491",
"primary": false
},
{
"code": "1835C0205X",
"taxonomy_group": "",
"desc": "Pharmacist, Critical Care",
"state": "FL",
"license": "PS52526",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.