D Bruce Wilson MD, PC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

MD009123 Issued in TN

Legal business name

D BRUCE WILSON MD, PC

Practice address

188 S Bellevue Blvd
#405
Memphis, TN 38104-3416

Phone

(901) 725-4400

Fax

(901) 516-8996

NPI assigned

Jun 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Donald Bruce Wilson, MD

Title

President

Phone

(901) 725-4400

Specialties & licenses 1

Addresses

Other identifiers 8

Locations

Practitioners 3

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

• James R Galyean, M.D.

  • Cardiovascular Disease Physician
  • Memphis, TN
  • NPI 1790785491
  NPD (past)
• Hany M Habashy, MD

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1285632224

  Cardiovascular Disease

  NPD (past)
• James O Patterson III, MD

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1457352106

  Cardiovascular Disease

  NPD (past)

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881890614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 S BELLEVUE BLVD",
            "address_2": "#405",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043416",
            "telephone_number": "901-725-4400",
            "fax_number": "901-516-8996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 S BELLEVUE BLVD",
            "address_2": "#405",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043416",
            "telephone_number": "901-725-4400",
            "fax_number": "901-516-8996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D BRUCE WILSON MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-725-4400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "MD009123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120197",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSSBLUE SHIELD",
            "identifier": "13799",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3388",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "511754",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00126945",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGN",
            "identifier": "4724230",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "89359",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3386286",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Disease Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Cardiovascular Disease Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.