Organization Active NPI

Deborah D Wilson M D P C

  • Obstetrics & Gynecology Physician
  • Scottsdale, AZ
National Provider Identifier
1811266331
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD26168 Issued in AZ
Legal business name
DEBORAH D WILSON M D P C
Practice address
10250 N 92ND St Ste 102
Scottsdale, AZ 85258-4517
Phone
(480) 860-4791
Fax
(480) 860-6314
NPI assigned
Dec 29, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Authorized official

Name
Ms. Deborah D. Wilson, M.D.NPI 1891742094
Title
Physician
Phone
(480) 860-4791

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X MD26168 AZ Primary

Addresses

Primary practice location

10250 N 92ND St Ste 102
Scottsdale, AZ 85258-4517

Mailing address

10250 N 92ND St Ste 102
Scottsdale, AZ 85258-4517
Phone (480) 860-4791

Other identifiers 1

IdentifierTypeStateIssuer
266701001MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211026001646 AZ Part B Supplier - Clinic/Group Practice 3870981756 Receives reassigned benefits from 6 practitioners
Practice locations: Scottsdale, AZ

National Provider Directory

National Provider Directory

Locations

10250 N 92nd St
Ste 102
Scottsdale, AZ 85258
Phone (480) 860-4791

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1811266331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10250 N 92ND ST STE 102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584517",
            "telephone_number": "480-860-4791",
            "fax_number": "480-860-6314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10250 N 92ND ST STE 102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584517",
            "telephone_number": "480-860-4791",
            "fax_number": "480-860-6314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORAH D WILSON M D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-29",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "480-860-4791",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "MD26168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266701001",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.