Active NPI
John Wilson III, CPRS
- Peer Specialist
- Knoxville, TN
National Provider Identifier
1982765772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 000-1216
- Practice address
- 201 W Springdale Ave
Knoxville, TN 37917-5158 - Phone
- (865) 637-9711
- NPI assigned
- Dec 13, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA47923 | FL | |
| Peer Specialist | 175T00000X | 000-1216 | TN | Primary |
Addresses
Primary practice location
201 W Springdale Ave
Knoxville, TN 37917-5158
Mailing address
201 W Springdale Ave
Knoxville, TN 37917-5158
Phone (865) 637-9711
Other practice location 1
320 W 3rd North St
Morristown, TN 37814-4038
Phone (423) 621-1454
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C4119 | Other | FL | BLUE CROSS PROVIDER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000-1216 | TN | MD | Peer Specialist |
| MA47923 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625184000000",
"number": "1982765772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 W SPRINGDALE AVE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379175158",
"telephone_number": "865-637-9711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 W SPRINGDALE AVE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379175158",
"telephone_number": "865-637-9711"
}
],
"practiceLocations": [
{
"address_1": "320 W 3rd North St",
"address_purpose": "LOCATION",
"city": "Morristown",
"state": "TN",
"postal_code": "378144038",
"country_code": "US",
"telephone_number": "423-621-1454",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "JOHN",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "CPRS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2021-07-02",
"certification_date": "2021-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA47923",
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "TN",
"license": "000-1216",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER",
"identifier": "C4119",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.