Active NPI
Michael Paul Wilson, OTC
- Technician/Technologist
- Springfield, PA
National Provider Identifier
1891201604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Technician/Technologist
- License
- 12-0205
- Practice address
- 324 Garden Rd
Springfield, PA 19064-3505 - Phone
- (610) 513-1001
- NPI assigned
- Dec 18, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Technician/Technologist | 156F00000X | 12-0205 | Primary |
Addresses
Primary practice location
324 Garden Rd
Springfield, PA 19064-3505
Mailing address
324 Garden Rd
Springfield, PA 19064-3505
Phone (610) 513-1001
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513555200000",
"number": "1891201604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "324 GARDEN RD",
"city": "SPRINGFIELD",
"state": "PA",
"postal_code": "190643505",
"telephone_number": "610-513-1001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "324 GARDEN RD",
"city": "SPRINGFIELD",
"state": "PA",
"postal_code": "190643505",
"telephone_number": "610-513-1001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MICHAEL",
"middle_name": "PAUL",
"credential": "OTC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-12-18",
"last_updated": "2017-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "156F00000X",
"taxonomy_group": "",
"desc": "Technician/Technologist",
"state": null,
"license": "12-0205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.