Individual provider Active NPI

Ellen M Wilson, D.C.

  • Chiropractor
  • Thomson, GA
National Provider Identifier
1821101569
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
02669 Issued in GA
Practice address
135 West Hill St.
Thomson, GA 30824-2110
Phone
(706) 597-0059
Fax
(706) 597-9100
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 02669 GA Primary

Addresses

Primary practice location

135 West Hill St.
Thomson, GA 30824-2110

Mailing address

135 West Hill St.
Thomson, GA 30824-2110
Phone (706) 597-0059

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
02669GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Adjust Chiropractic LLC Chiropractor CurrentSince Jan 14, 2021 Accepting new patients

Locations

135 W Hill St
Thomson, GA 30824
Phone (706) 597-0059

Organizations & group practices 1

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821101569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 WEST HILL ST.",
            "city": "THOMSON",
            "state": "GA",
            "postal_code": "308242110",
            "telephone_number": "706-597-0059",
            "fax_number": "706-597-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 WEST HILL ST.",
            "city": "THOMSON",
            "state": "GA",
            "postal_code": "308242110",
            "telephone_number": "706-597-0059",
            "fax_number": "706-597-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ELLEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "02669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomson, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.