Stanley J Wilson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

36325 Issued in MO

Practice address

3401 W 10TH St
Sedalia, MO 65301-2112

Phone

(660) 827-2883

Fax

(660) 827-1359

NPI assigned

Apr 28, 2006

Last updated

Mar 2, 2017By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Family Practice

Education

University of Missouri, Columbia School of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bothwell Regional Health CenterGroup PAC ID 6103714126, 109 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bothwell Regional Health Center Hospital, Sedalia, MO, CCN 260009

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Bothwell Regional Health Center

  • General Acute Care Hospital
  • Sedalia, MO
  • NPI 1235102690
  Medicare reassignment Care Compare group NPD
• Camden Emergency Group LLC

  • Emergency Medicine Physician
  • Osage Beach, MO
  • NPI 1003181637
  Medicare reassignment NPD
• Southeastern Emergency Physicians of Memphis LLC

  • Emergency Medicine Physician
  • Alton, IL
  • NPI 1437105277

  MO

  Medicare reassignment NPD
• Bothwell Regional Health Center

  dba Cole Camp Clinic

  • Rural Health Clinic/Center
  • Cole Camp, MO
  • NPI 1497705313

  Family Medicine

  NPD
• Bothwell Regional Health Center

  dba Bothwell Physicians Group

  • General Practice Physician
  • Sedalia, MO
  • NPI 1508239781
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bothwell Regional Health Center

  • General Acute Care Hospital
  • Sedalia, MO
  • NPI 1235102690
  Care Compare affiliation
• Bothwell Regional Health Center

  dba Cole Camp Clinic

  • Rural Health Clinic/Center
  • Cole Camp, MO
  • NPI 1497705313

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1821055211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 DOGWOOD CIR",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653018900",
            "telephone_number": "660-827-2883",
            "fax_number": "660-827-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 W 10TH ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012112",
            "telephone_number": "660-827-2883",
            "fax_number": "660-827-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "STANLEY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "36325",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "36325",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201709516",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John N Willadsen, LPC
• Brittney Williams
• Tara Marie-Minx Williams
• Katie Marie Wills, CRNA
• Michael Alexander Wilshusen, DPT
• Chad J. Wimer, DDS
• Windmiller Dental LLC
• Glory Lynn Windmiller, DDS
• Robin Wollard, FNP
• Womens Health & Surgical Center MDS PC

• Family Medicine Physician in Sedalia, MO
• Providers in Sedalia, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; 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.