Individual provider Active NPI

James Marion Wilson, M.D.

  • Urology Physician
  • Johnson City, TN
National Provider Identifier
1962443226
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD0000009412 Issued in TN
Practice address
James Quillen Medical Center
Moutain Home VA
Johnson City, TN 37684
Phone
(423) 926-1171
Fax
(423) 979-3427
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD0000009412 TN Primary

Addresses

Primary practice location

James Quillen Medical Center
Moutain Home VA
Johnson City, TN 37684

Mailing address

1913 Millbrook Dr
Johnson City, TN 37604-1485
Phone (423) 282-5612

Other identifiers 1

IdentifierTypeStateIssuer
3172401MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140501001995 TN Order and Referring Only - UrologyPractitioner - Urology 1759514573

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1962443226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1913 MILLBROOK DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041485",
            "telephone_number": "423-282-5612",
            "fax_number": "423-282-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JAMES QUILLEN MEDICAL CENTER",
            "address_2": "MOUTAIN HOME VA",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37684",
            "telephone_number": "423-926-1171",
            "fax_number": "423-979-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JAMES",
        "middle_name": "MARION",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TN",
            "license": "MD0000009412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3172401",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.