DR. JEFFREY JOHN WILSON M.D.
NPI 1811015092
Psychiatry & Neurology - Child & Adolescent Psychiatry in Roanoke, VA

Q: What is Jeffrey Wilson's NPI number?

The NPI number for Jeffrey Wilson is 1811015092. It was assigned to this individual provider in the NPPES registry on March 27, 2007.

Q: What is Jeffrey Wilson's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Q: When was this NPI record last updated?

The NPPES record for Jeffrey Wilson was last updated on December 24, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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 March 27, 2007PECOS Enrolled

2017 JEFFERSON ST SW, ROANOKE, VA 24014(540) 853-0900(540) 853-0518 Get Directions Write a Review

NPPES record last updated: December 24, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Jeffrey John Wilson M.d. NPPES

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

DR. JEFFREY JOHN WILSON M.D. (NPI 1811015092) is an individual child & adolescent psychiatry provider in Roanoke, Virginia, licensed in Virginia (0101-256187) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1811015092

Entity TypeIndividualMale

Primary Taxonomy2084P0804X

Provider Legal NameDR. JEFFREY JOHN WILSONCredential: M.D.

Location Address2017 JEFFERSON ST SWRoanoke, VA 24014-2419

Mailing Address2017 Jefferson St SwRoanoke, VA 24014-2419 · (540) 853-0900 · Fax (540) 853-0518

Phone(540) 853-0900

Fax(540) 853-0518

Sole ProprietorNo

Enumeration DateMarch 27, 2007

Last NPPES UpdateDecember 24, 2014

✔ NPI 1811015092 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0804X

Licenses✔ Licensed in VA · 0101-256187✔ Licensed in UT · 8225057

Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 8225057 (UT), 0101-256187 (VA)

Also ListedPsychiatry & Neurology · Addiction PsychiatryTaxonomy 2084P0802X · License 8225057 (UT), 0101-256187 (VA)

2017 JEFFERSON ST SW, Roanoke, VA 24014

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Other Identifiers 2

OtherVVD703AVA · Medicare Ptan

Medicare UPINH32968

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jeffrey John Wilson M.d. 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.

RODNEY JAMES SNODGRASS DEATON M.D.

Psychiatry & Neurology (Psychiatry)