NPI Record of DR. JOHN M. WILSON M.D. NPI 1164423836

Psychiatry & Neurology (Psychiatry) in Lynchburg, VA

Complete NPI Record


Field Name Value Definition
NPI1164423836National Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code1Entity type code (type of health care provider assigned an NPI).
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Last Name Legal NameWILSONProvider last name.
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First NameJOHNProvider first name.
The first name of the provider, if the provider is an individual.
Provider Middle NameM.Provider middle name.
The middle name of the provider, if the provider is an individual.
Provider Name Prefix TextDR.Provider name prefix text.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Credential TextM.D.Provider credential text.
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address1204 FENWICK DRProvider first line mailing address.
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City NameLYNCHBURGProvider mailing address city name.
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NameVAProvider mailing address State name.
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code245022112Provider mailing address postal code.
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S USProvider mailing address country code.
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider First Line Business Practice Location Address3300 RIVERMONT AVEProvider first line location address.
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameLYNCHBURGProvider location address city name.
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameVAProvider location address State code.
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code245032030Provider location address postal code.
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S USProvider location address country code.
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number4342005999Provider location address telephone number.
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date8/3/2005Provider enumeration date.
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date3/13/2008Last update date.
The date that a record was last updated or changed.
Provider Gender CodeMProvider gender code.
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 12084P0800XProvider taxonomy code.
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 10101056617Provider license number.
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1VAProvider license number State code.
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1Y
Other Provider Identifier 12019602Other provider identifier.
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 101Other provider identifier type code.
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 1CIGNA BEHAVIOR PROVIDER N
Other Provider Identifier 2239524Other provider identifier.
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 201Other provider identifier type code.
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 2VALUE OPTIONS PROVIDER NU
Other Provider Identifier 3O88170Other provider identifier.
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 301Other provider identifier type code.
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 3VA
Other Provider Identifier Issuer 3SENTARA PROVIDER NUMBER
Other Provider Identifier 4203639329001Other provider identifier.
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 401Other provider identifier type code.
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 4VA
Other Provider Identifier Issuer 4TRICARE PROVIDER NUMBER
Other Provider Identifier 5186475Other provider identifier.
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 501Other provider identifier type code.
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 5VA
Other Provider Identifier Issuer 5ANTHEM PROVIDER NUMBER
Is Sole ProprietorNIs Sole Proprietor.
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No