CANDACE ELIZABETH WILSON MD
NPI 1053163410
Student in an Organized Health Care Education/Training Program in Memphis, TN

Q: What is Candace Wilson's NPI number?

The NPI number for Candace Wilson is 1053163410. It was assigned to this individual provider in the NPPES registry on April 1, 2024.

Q: What is Candace Wilson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Candace Wilson was last updated on April 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 01, 2024PECOS Enrolled

1301 PRIMACY PKWY, MEMPHIS, TN 38119(901) 448-0230(901) 448-0404 Get Directions Write a Review

NPPES record last updated: April 1, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Candace Elizabeth Wilson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CANDACE ELIZABETH WILSON MD (NPI 1053163410) is an individual student in an organized health care education/training program in Memphis, Tennessee and active in the NPI registry since April 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053163410

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameCANDACE ELIZABETH WILSONCredential: MD

Location Address1301 PRIMACY PKWYMemphis, TN 38119-0213

Mailing Address1301 Primacy PkwyMemphis, TN 38119-0213 · (901) 448-0230 · Fax (901) 448-0404

Phone(901) 448-0230

Fax(901) 448-0404

Sole ProprietorNo

Enumeration DateApril 1, 2024

NPPES CertifiedApril 1, 2024

✔ NPI 1053163410 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1301 PRIMACY PKWY, Memphis, TN 38119

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Candace Elizabeth Wilson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CHRISTINA BROWN TRAN MD

Family Medicine