Daniel G Wilson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2944 Issued in FL

Practice address

1821 Blanding Blvd
Suite 1
Middleburg, FL 32068-3839

Phone

(904) 406-3160

Fax

(904) 406-3159

NPI assigned

Feb 1, 2006

Last updated

Nov 29, 2016By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Formoso Pain Specialists, PA

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Jacksonville, FL
  • NPI 1487270351
  NPD
• Physicians Group Services PA

  dba Coastal Health

  • Family Medicine Physician
  • Orange Park, FL
  • NPI 1861440810
  NPD (past)

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1831160332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850001",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328850192",
            "telephone_number": "904-282-6331",
            "fax_number": "904-282-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 BLANDING BLVD",
            "address_2": "SUITE 1",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320683839",
            "telephone_number": "904-406-3160",
            "fax_number": "904-406-3159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DANIEL",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA2944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shermell Williams
• Sarah Elaine Williford, PHARMD
• Amy Wilson
• Brittany Wilson, PMHNP
• Crystal Nicole Wilson
• Molly Winger
• Sharon Renee Winner, PSYD
• Misty Wright, CNA
• Robin Wright, RN
• Shelli J Wynkoop

• Medical Physician Assistant in Middleburg, FL
• Providers in Middleburg, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.