Active NPI
John Robert Wilson, R.PH.
- Pharmacist
- Birmingham, AL
National Provider Identifier
1962539536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 10123
- Practice address
- 1528 Carraway Blvd
Birmingham, AL 35234-1998 - Phone
- (205) 502-1010
- NPI assigned
- Feb 28, 2007
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 10123 | AL | Primary |
Addresses
Primary practice location
1528 Carraway Blvd
Birmingham, AL 35234-1998
Mailing address
341 Walker Chapel PLZ Ste 109
Fultondale, AL 35068-3404
Phone (205) 502-1010
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100002687 | Medicaid | AL | |
| 0115281 | Other | AL | NCPDP NUMBER |
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10123 | AL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Jefferson Pharmacy, Inc. | Past | Accepting new patients |
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.
-
- Community/Retail Pharmacy
- Fultondale, AL
- NPI 1396873782
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514505600000",
"number": "1962539536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "341 WALKER CHAPEL PLZ STE 109",
"city": "FULTONDALE",
"state": "AL",
"postal_code": "350683404",
"telephone_number": "205-502-1010",
"fax_number": "866-228-0184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1528 CARRAWAY BLVD",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352341998",
"telephone_number": "205-502-1010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JOHN",
"middle_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-28",
"last_updated": "2017-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "10123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100002687",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP NUMBER",
"identifier": "0115281",
"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 Dec 29, 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.