Karen L Wilson, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

036103153 Issued in IL

Practice address

3811 Valley Centre Dr
San Diego, CA 92130

Phone

(858) 764-3030

NPI assigned

Jul 19, 2005

Last updated

Sep 24, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kwilson159821@scrippshlth.medalliesdirect.net

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.

• Scripps Health

  dba Scripps Hospital Medical Services

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• Scripps Clinic Medical Group

  • Multi-Specialty Clinic/Center
  • San Diego, CA
  • NPI 1124003280
  NPD (past)
• Scripps Health

  dba Scripps Memorial Hospital La Jolla

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704
  NPD (past)
• Ann & Robert H Lurie Childrens Hospital of Chicago

  • Children's Hospital
  • Chicago, IL
  • NPI 1538279518
  NPD (past)
• Child & Adolescent Health Assoc LTD

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1346230299
  NPD (past)
• Northwestern Memorial Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1578672895
  NPD (past)
• Northwestern Memorial Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1861609208
  NPD (past)

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1851390025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 VALLEY CENTRE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303318",
            "telephone_number": "858-764-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 VALLEY CENTRE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92130",
            "telephone_number": "858-764-3030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1030 N Clark St",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606105467",
            "country_code": "US",
            "telephone_number": "312-943-6964",
            "fax_number": "312-943-6924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KAREN",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IL",
            "license": "036103153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036103153",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jesse Wilson
• Jessica M Wilson
• Jocelyn Wilson
• Kaitlyn Nichole Wilson, LPCC 14444
• Kalayah Umoni Noel Wilson
• Karen R Wilson, M.S.
• Kasey Wilson
• Katherine Wilson, MD
• Kera Wilson, APCC
• Kiana Michelle Wilson

• Pediatric Adolescent Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Pediatric Adolescent Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.

Verify at the official NPI Registry.