Matthew Wilson LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2008006048 Issued in MO

Legal business name

MATTHEW WILSON LLC

Doing business as

Matthew Wilson, M.D.

Practice address

621 S New Ballas Rd
Tower a, Suite 398
Saint Louis, MO 63141-8232

Phone

(314) 251-7720

Fax

(314) 251-7722

NPI assigned

Apr 15, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Stewart Wilson, M.D.

Title

Member

Phone

(314) 251-7720

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Matthew Wilson, M.D. Doing business as

Locations

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1871767475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "TOWER A, SUITE 398",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-7720",
            "fax_number": "314-251-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "TOWER A, SUITE 398",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-7720",
            "fax_number": "314-251-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW WILSON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "STEWART",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "314-251-7720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2008006048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI MATTHEW S. WILSON MD",
            "identifier": "1649392796",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Matthew Wilson, M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tobias Alecio Mattei, M.D.
• Brittany Erin Matteucci
• Thomas M Matthes, DDS
• Matthew Morgan Henderson Counseling LLC
• Matthew T. Ricks DO LLC
• Janet Matthew
• Jermaine Orlando Matthew, LPN
• Christina M Matthews, CPNP-PC
• Daisy Matthews
• Jenna Matthews

• Psychiatry Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.