Individual provider Active NPI

Jon Lloyd Wilson, L.M.S.W.

  • Clinical Social Worker
  • Dearborn, MI
National Provider Identifier
1912170333
Registry record updated Sep 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801079069 Issued in MI
Practice address
18181 Oakwood Blvd
Oakwood Medical Building Suite 311
Dearborn, MI 48124-5032
Phone
(313) 271-8170
Fax
(313) 271-8353
NPI assigned
Apr 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801079069 MI Primary

Addresses

Primary practice location

18181 Oakwood Blvd
Oakwood Medical Building Suite 311
Dearborn, MI 48124-5032

Mailing address

6 Parklane Blvd
Ste 695
Dearborn, MI 48126-2776
Phone (313) 271-8170

Other identifiers 1

IdentifierTypeStateIssuer
6801079069OtherMIL.M.S.W.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120223000744 MI Practitioner - Clinical Social Worker 9638337553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apex Behavioral Health Dearborn PLLCGroup PAC ID 7911165949, 9 clinicians

Practice addresses (Care Compare)

6 Parklane Blvd
Suite 695
Dearborn, MI 48126-2776
Phone (313) 271-8170

Merit-based Incentive Payment System (MIPS)

Final score
98.67 of 100Reported as group
Quality
99.29
Improvement activities
40
Cost
87.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Behavioral Health Dearborn PLLC CurrentSince Nov 28, 2011 Accepting new patients

Locations

6 Parklane Blvd
Ste 695
Dearborn, MI 48126
Phone (313) 271-8170

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1912170333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 PARKLANE BLVD",
            "address_2": "STE 695",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262776",
            "telephone_number": "313-271-8170",
            "fax_number": "313-271-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18181 OAKWOOD BLVD",
            "address_2": "OAKWOOD MEDICAL BUILDING SUITE 311",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481245032",
            "telephone_number": "313-271-8170",
            "fax_number": "313-271-8353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JON",
        "middle_name": "LLOYD",
        "name_prefix": "Mr.",
        "credential": "L.M.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-07",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801079069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L.M.S.W.",
            "identifier": "6801079069",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.