Benjamin Gregg Wilson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

10527 Issued in TX

Practice address

1040 S Fleishel Ave
Suite 4
Tyler, TX 75701-2044

Phone

(903) 535-9355

NPI assigned

Mar 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wilson Chiropractic and Acupuncture PLLC

  • Chiropractor
  • Tyler, TX
  • NPI 1720293699
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952439028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 MCDONALD RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757016224",
            "telephone_number": "903-565-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 S FLEISHEL AVE",
            "address_2": "SUITE 4",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012044",
            "telephone_number": "903-535-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BENJAMIN",
        "middle_name": "GREGG",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "10527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willow Wellness Center, P.a.
• James M Willtrout
• Wilson Chiropractic and Acupuncture PLLC
• Wilson Renfroe, PSYD, PLLC
• Alexander Wilson, PT, DPT
• Braden Wilson, MD
• Clark Alexander Wilson, MD
• Damere Tianna Wilson, PHD
• Daniel Wilson, DO
• Dawn Marcelle Wilson, LCSW

• Chiropractor in Tyler, TX
• Providers in Tyler, TX by specialty
• Chiropractor in Texas

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.