DR. NICOLE EDITH WILSON (NPI# 1073806956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073806956 |
| Entity Type | Individual |
| Full Name | DR. NICOLE EDITH WILSON |
| Other Name | DR. NICOLE EDITH ALLEN-WILSON |
| Credential | D.P.M. |
| Practice Address |
204 Westside Dr Douglas GA 31533-3528 |
| Practice Telephone | 9123844121 |
| Practice Fax Number | 9123891817 |
| Mailing Telephone | 9123844121 |
| Mailing Fax Number | 9123891817 |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2016-02-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
POD001284 | GA | Podiatric Medicine & Surgery Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326544545 | Nicole Wilson | Occupational Therapy Assistant | 17415 N 92nd Ave, Peoria, AZ 85382-8214 | 2018-04-05 |
| 1679014997 | Nicole Lynn Wilson | Nurse's Aide | 2054 Magee St, Down, Lakewood, OH 44107-5238 | 2017-03-20 |
| 1598214801 | Nicole Wilson | Specialist/Technologist | 81 E Broadway St, Ipava, IL 61441-5236 | 2016-09-27 |
| 1144663725 | Nicole Ann Wilson | Military Health Care Provider | 4701 Apple Tree Dr, Alexandria, VA 22310-2802 | 2013-04-12 |
| 1851681027 | Nicole Wilson | Contractor | 933 N Rivershire Dr, Conroe, TX 77304-2793 | 2011-04-08 |
| 1275845547 | Nicole Olivia Wilson | Nurse Practitioner | 914 1st Ave Se, Minot, ND 58701-4008 | 2010-07-02 |
| 1093941056 | Nicole Sharee Wilson | Chiropractor | 1455 Westfield Ave Sw, North Canton, OH 44720-4235 | 2009-06-04 |
| 1891929923 | Nicole Marie Wilson | Chiropractor | 1411 Nw Raleigh Street, Portland, OR 97209-2573 | 2009-05-04 |
| 1902044217 | Nicole Ann Wilson | Pharmacist | 4 Railroad Street, St. Marys, PA 15857-1798 | 2009-01-23 |
| 1396344883 | Nicole Wilson | Technician | 111 Virginia Ave, Petersburg, WV 26847-1713 | 2020-10-26 |
| Street Address |
204 WESTSIDE DR |
| City | DOUGLAS |
| State | GA |
| Zip Code | 31533-3528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598793283 | Gregory J Kramer | Podiatrist | 204 Westside Dr, Douglas, GA 31533-3528 | 2006-06-29 |
| 1194265439 | Ankle and Foot Assoc, LLC | Podiatrist | 204 Westside Dr, Douglas, GA 31533-3528 | 2017-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508470964 | Swain Drug Company LLC | Pharmacy | 855 Bowens Mill Rd Sw Suite E, Douglas, GA 31533 | 2020-09-03 |
| 1811528649 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 211 North Street, Douglas, GA 31533 | 2020-01-30 |
| 1952940793 | Teresa Smith | Pharmacist | 901 W Ward St, Douglas, GA 31533 | 2019-12-26 |
| 1447641048 | Jennifer Spivey | Nurse Practitioner | 326 Shirley Avenue, Douglas, GA 31533 | 2015-02-18 |
| 1972914497 | Jessica Lynne Courson | Nurse Practitioner | 903 West Ward Street, Suite B, Douglas, GA 31533 | 2014-05-19 |
| 1063840296 | South Central Primary Care Center | Clinic/Center | 303 Shirley Ave, Ste B, Douglas, GA 31533 | 2013-10-25 |
| 1336411008 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 118 Coweta Avenue South, Douglas, GA 31533 | 2012-01-27 |
| 1346482700 | V and V Clinic | Pediatrics | 1020 West Bryan Street, Douglas, GA 31533 | 2009-04-01 |
| 1063650406 | Jayla Snipes Bullock | Speech-Language Pathologist | 618 Bowens Mill Road Sw, Douglas, GA 31533 | 2009-01-22 |
| 1417112707 | Southern Community Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 315 S. Gaskin Ave, Douglas, GA 31533 | 2008-07-25 |
| Find all providers in zip 31533 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194265439 | Ankle and Foot Assoc, LLC | Podiatrist | 204 Westside Dr, Douglas, GA 31533-3528 | 2017-03-06 |
| 1932118189 | Craig S Capron | Podiatrist | 111 S 5th St, Douglas, WY 82633-2434 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518515980 | Da Vinci Foot and Ankle Madison LLC | Podiatrist | 1740 Lions Club Rd Ste 200, Madison, GA 30650-4762 | 2019-08-29 |
| 1376191106 | Ryan Goldfine Dpm LLC | Podiatrist | 3451 Ernest W Barrett Pkwy Suite 170, Mariettta, GA 30269 | 2019-08-26 |
| 1073076170 | Kalish Foot & Ankle Institute | Podiatrist | 6911 Tara Blvd Ste 101, Jonesboro, GA 30236-1503 | 2019-04-08 |
| 1427523919 | Tommy Lee Tally | Podiatrist | 8225 Mall Pkwy Ste 230, Lithonia, GA 30038-6913 | 2018-10-10 |
| 1881188944 | Joshua Jae Lee | Podiatrist | 3425 Buford Dr Ste 350, Buford, GA 30519-8785 | 2018-06-21 |
| 1437652815 | Southeast Regional Primary Care Corporation | Podiatrist | 1707 Meadows Ln Ste H, Vidalia, GA 30474-7201 | 2018-03-13 |
| 1447762927 | Ponders Podiatry LLC | Podiatrist | 275 Carpenter Drive Ne, Suite 106, Atlanta, GA 30328 | 2017-10-24 |
| 1194245894 | Yusuf Abiodun Opakunle | Podiatrist | 600 Professional Dr Ste 130, Lawrenceville, GA 30046-7638 | 2017-06-23 |
| 1891228540 | Vishal Patel | Podiatrist | 755 Mount Vernon Hwy Ne Ste 210, Atlanta, GA 30328-4279 | 2017-04-10 |
| 1497296552 | Ankle and Foot Assoc, LLC | Podiatrist | 118 Azalea Rd, Suite 1-2, Baxley, GA 31513-0672 | 2017-03-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.