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

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: October 18, 2026.

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
Open in Google Maps ↗

Other Identifiers 2

OtherVVD703AVA · Medicare Ptan
Medicare UPINH32968

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Jeffrey Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Childrens Specialty Group PLLC
203 mi
Pediatrics
601 CHILDRENS LN
Norfolk, VA 23507
  • Reassigned Medicare billing, Virginia enrollment
  • 549 clinicians in this Medicare group
NPI 1255354130 (757) 668-7007

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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)
2017 JEFFERSON ST SW
ROANOKE, VA 24014
Roanoke City (540) 981-8025
JOHN H DRAEGER MD
Psychiatry & Neurology (Psychiatry)
2017 JEFFERSON ST SW
ROANOKE, VA 24014
Roanoke City (540) 853-0900
STEPHANIE DIANN SYLVESTER-JOHNSON RN, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
2017 JEFFERSON ST SW
ROANOKE, VA 24014
Roanoke City (540) 355-6860
DR. JOHN ERIC VANCE M.D
Psychiatry & Neurology (Psychiatry)
2017 JEFFERSON ST SW
ROANOKE, VA 24014
Roanoke City (540) 853-0900
SHERIFAT I FORCEY NP
Nurse Practitioner (Psychiatric/Mental Health)
2017 JEFFERSON ST SW
ROANOKE, VA 24014
Roanoke City (540) 981-8025
SOORAJ JOHN MD
Psychiatry & Neurology (Psychiatry)
2017 JEFFERSON ST SW
ROANOKE, VA 24014
Roanoke City (540) 981-8025
ANTHONY CIAFARDINI LPC
Counselor (Mental Health)
2017 JEFFERSON ST SW
ROANOKE, VA 24014
Roanoke City (540) 981-8181
MR. GUSTAF ANDERS SYLVESTER-JOHNSON FNP-BC
Nurse Practitioner (Family)
2017 JEFFERSON ST SW
ROANOKE, VA 24014
Roanoke City (540) 981-8025

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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.

Where is Jeffrey Wilson located?

Jeffrey Wilson practices at 2017 Jefferson St SW, Roanoke, VA 24014. The listed phone number is (540) 853-0900.

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.

Is Jeffrey Wilson enrolled in Medicare?

Yes. Jeffrey Wilson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jeffrey Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeffrey Wilson reassigns Medicare benefits to Childrens Specialty Group PLLC (Norfolk, VA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jeffrey Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

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.