Individual provider Active NPI

Jennifer Lynn Wilkerson, M.D.

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1982617239
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K2826 Issued in TX
Practice address
3417 Gaston Ave
Suite 700
Dallas, TX 75246-2016
Phone
(214) 823-4800
Fax
(214) 823-4801
NPI assigned
Aug 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X K2826 TX Primary

Addresses

Primary practice location

3417 Gaston Ave
Suite 700
Dallas, TX 75246-2016

Mailing address

3417 Gaston Ave
Suite 700
Dallas, TX 75246-2016
Phone (214) 823-4800

Other identifiers 2

IdentifierTypeStateIssuer
046194901MedicaidTX
84426XOtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100513000312 TX Practitioner - Internal Medicine 0547398489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Southwestern Medical School at Dallas, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Abksw Preferred Health Partners, PLLCGroup PAC ID 2961710892, 48 clinicians

Practice addresses (Care Compare)

3417 Gaston Ave
Suite 700
Dallas, TX 75246-2031
Phone (241) 823-4800

440 W
635 Suite 405
Irving, TX 75063
Phone (972) 993-5080

Hospital & facility affiliations

  • Baylor University Medical Center Hospital, Dallas, TX, CCN 450021
  • Texas Health Presbyterian Hospital Dallas Hospital, Dallas, TX, CCN 450462
  • Medical City Dallas Hospital Hospital, Dallas, TX, CCN 450647
  • Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036
  • The Legacy Midtown Park Nursing home, Dallas, TX, CCN 676489

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Abksw Preferred Health Partners, PLLC Internal Medicine CurrentSince Oct 1, 2015 Accepting new patients

Locations

3417 Gaston Ave
Ste 700
Dallas, TX 75246
Phone (214) 823-4800

440 W Lyndon B Johnson Fwy
Ste 405
Irving, TX 75063
Phone (214) 823-4800

Interoperability endpoints

  • Direct secure messaging: jennifer.wilkerson@ntphp.eclinicaldirectplus.com

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1982617239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 GASTON AVE",
            "address_2": "SUITE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462016",
            "telephone_number": "214-823-4800",
            "fax_number": "214-823-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 GASTON AVE",
            "address_2": "SUITE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462016",
            "telephone_number": "214-823-4800",
            "fax_number": "214-823-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K2826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046194901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "84426X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.