Active NPI
Thomas A Wilson Jr., MD
- Neurological Surgery Physician
- Birmingham, AL
National Provider Identifier
1942397971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 17154
- Practice address
- 800 St Vincents Drive
#700
Birmingham, AL 35205 - Phone
- (205) 933-8981
- Fax
- (205) 930-0746
- NPI assigned
- Oct 10, 2006
- 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 |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 17154 | AL | Primary |
Addresses
Primary practice location
800 St Vincents Drive
#700
Birmingham, AL 35205
Mailing address
800 St Vincents Drive
#700
Birmingham, AL 35205
Phone (205) 933-8981
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52820186 | Medicaid | AL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17154 | AL | MD | Neurological Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942397971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 ST VINCENTS DRIVE",
"address_2": "#700",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "35205",
"telephone_number": "205-933-8981",
"fax_number": "205-930-0746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 ST VINCENTS DRIVE",
"address_2": "#700",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "35205",
"telephone_number": "205-933-8981",
"fax_number": "205-930-0746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "THOMAS",
"middle_name": "A",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "AL",
"license": "17154",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "52820186",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.