Active NPI
Walter W Wilson, M.D.
- Family Medicine Physician
- Springville, AL
National Provider Identifier
1821184334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 12105
- Practice address
- 1000 Saint Clair Rd
Springville, AL 35146-5582 - Phone
- (205) 467-6111
- Fax
- (205) 467-1760
- NPI assigned
- Oct 4, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 12105 | AL | Primary |
Addresses
Primary practice location
1000 Saint Clair Rd
Springville, AL 35146-5582
Mailing address
1000 Saint Clair Rd
Springville, AL 35146-5582
Phone (205) 467-6111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000097542 | Medicaid | AL |
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
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Correctional Medical Services | Past | Accepting new patients |
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.
-
- Rural Health Clinic/Center
- Springville, AL
- NPI 1164625968
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519948800000",
"number": "1821184334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 SAINT CLAIR RD",
"city": "SPRINGVILLE",
"state": "AL",
"postal_code": "351465582",
"telephone_number": "205-467-6111",
"fax_number": "205-467-1760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 SAINT CLAIR RD",
"city": "SPRINGVILLE",
"state": "AL",
"postal_code": "351465582",
"telephone_number": "205-467-6111",
"fax_number": "205-467-1760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "WALTER",
"middle_name": "W",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2018-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AL",
"license": "12105",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000097542",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.