Active NPI
Deborah A Wilson, MD
- Rheumatology Physician
- Minocqua, WI
National Provider Identifier
1861592289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 27515
- Practice address
- 9601 Townline Rd
Minocqua, WI 54548-9099 - Phone
- (715) 358-1840
- Fax
- (715) 358-1331
- NPI assigned
- Sep 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 27515 | WI | |
| Rheumatology Physician | 207RR0500X | 27515 | WI | Primary |
Addresses
Primary practice location
9601 Townline Rd
Minocqua, WI 54548-9099
Mailing address
9601 Townline Rd
Minocqua, WI 54548-9099
Phone (715) 358-1840
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30719800 | Medicaid | WI |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384560000000",
"number": "1861592289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9601 TOWNLINE RD",
"city": "MINOCQUA",
"state": "WI",
"postal_code": "545489099",
"telephone_number": "715-358-1840",
"fax_number": "715-358-1331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9601 TOWNLINE RD",
"city": "MINOCQUA",
"state": "WI",
"postal_code": "545489099",
"telephone_number": "715-358-1840",
"fax_number": "715-358-1331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "DEBORAH",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-25",
"last_updated": "2013-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "27515",
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "WI",
"license": "27515",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30719800",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minocqua, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.