Organization Active NPI

Wilson Psychology Group LLC

  • Psychologist
  • Anniston, AL
National Provider Identifier
1851981641
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
WILSON PSYCHOLOGY GROUP LLC
Practice address
1115 Leighton Ave Ste 1-a
Anniston, AL 36207-4610
Phone
(256) 238-8113
Fax
(256) 238-8955
NPI assigned
Jan 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Authorized official

Name
Dr. Emma Hiatt WilsonNPI 1184829145
Title
Licensed Psychologist
Phone
(256) 238-8113

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

1115 Leighton Ave Ste 1-a
Anniston, AL 36207-4610

Mailing address

1115 Leighton Ave Ste 1-a
Anniston, AL 36207-4610
Phone (256) 238-8113

Other identifiers 1

IdentifierTypeStateIssuer
1184829145MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210518000218 AL Part B Supplier - Clinic/Group Practice 4981013240 Receives reassigned benefits from 1 practitioner
Practice locations: Anniston, AL

National Provider Directory

National Provider Directory

Locations

1115 Leighton Ave
Ste 1A
Anniston, AL 36207
Phone (256) 238-8113

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23314/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611532800000",
    "number": "1851981641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 LEIGHTON AVE STE 1-A",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362074610",
            "telephone_number": "256-238-8113",
            "fax_number": "256-238-8955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 LEIGHTON AVE STE 1-A",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362074610",
            "telephone_number": "256-238-8113",
            "fax_number": "256-238-8955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON PSYCHOLOGY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "EMMA",
        "authorized_official_middle_name": "HIATT",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "256-238-8113",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184829145",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anniston, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.