Sally King Wilson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301068222 Issued in MI

Practice address

121 S Cochran Ave
Suite C
Charlotte, MI 48813-1568

Phone

(517) 543-9095

Fax

(517) 543-3339

NPI assigned

Jul 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Sally King Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Sparrow Ionia Hospital

  • Family Medicine Physician
  • Ionia, MI
  • NPI 1033271143
  NPD (past)
• Sparrow Ionia Hospital

  • Critical Access Hospital
  • Ionia, MI
  • NPI 1700820065
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1992711964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S COCHRAN AVE",
            "address_2": "SUITE C",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488131568",
            "telephone_number": "517-543-9095",
            "fax_number": "517-543-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S COCHRAN AVE",
            "address_2": "SUITE C",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488131568",
            "telephone_number": "517-543-9095",
            "fax_number": "517-543-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SALLY",
        "middle_name": "KING",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301068222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLY",
            "last_name": "KING",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Harper T Wildern, O.D.
• Jeffrey Alan Wildern
• Wilderns Drug Store
• Jessica Marie Wilkinson, RN
• Karri Wills, PT
• Holly Gene Wixon
• Jason J Wojnar
• Douglas Dane Wolford, D.O.
• Woodward Detroit CVS, L.L.C.
• Kelsey Lynn Wright, PT, DPT

• Family Medicine Physician in Charlotte, MI
• Providers in Charlotte, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.