JULIE WILSON (NPI# 1093934267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093934267 |
| Entity Type | Individual |
| Full Name | JULIE WILSON |
| Credential | D.O. |
| Practice Address |
3210 Eagle Run Dr Ne Suite 100 Grand Rapids MI 49525-7051 |
| Practice Telephone | 6169571200 |
| Practice Fax Number | 6169571297 |
| Mailing Telephone | 6169571200 |
| Mailing Fax Number | 6169571297 |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2015-09-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
5101015505 | MI | Allopathic & Osteopathic Physicians |
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
5101015505 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639533912 | Julie Wilson | Nurse Practitioner | 2377 Fairview Blvd, Fairview, TN 37062-6003 | 2016-04-12 |
| 1992069702 | Julie Anne Wilson | Massage Therapist | 119 S 2nd St, Selah, WA 98942-1307 | 2012-06-26 |
| 1346547775 | Julie Fitzgerald Wilson | Speech-Language Pathologist | 1925 Pauline Blvd, Suite B, Ann Arbor, MI 48103-5046 | 2011-02-21 |
| 1649421744 | Julie Ann Wilson | Licensed Practical Nurse | 202 Rand St, Rochester, NY 14615-3320 | 2008-10-07 |
| 1083894661 | Julie Wilson | Registered Nurse | 95 Clear Spring Ln, Oxford, GA 30054-4632 | 2007-11-12 |
| 1124227301 | Julie Keebler Wilson | Counselor | 600 301 Blvd W, Suite 144, Bradenton, FL 34205-7957 | 2007-07-17 |
| 1144384272 | Julie Ann Wilson | Speech-Language Pathologist | 6109 Maple, Houston, TX 77074 | 2006-12-21 |
| 1942818729 | Julie Ann Wilson | Registered Nurse | 1101 W Gannon Dr, Festus, MO 63028-2602 | 2020-07-17 |
| 1578122834 | Julie Ann Wilson | Physician Assistant | 112 N 5th St, Barnsdall, OK 74002-6616 | 2019-06-11 |
| 1366008799 | Julie Rae Wilson | Counselor | 5900 Brockton Ave, Riverside, CA 92506-1862 | 2019-05-10 |
| Street Address |
3210 EAGLE RUN DR NE SUITE 100 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49525-7051 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992784722 | Donald Gregory Weston IIi | Anesthesiology | 3210 Eagle Run Dr Ne, Suite 100, Grand Rapids, MI 49525-7051 | 2006-01-11 |
| 1891259339 | Hope Network Recovery | Substance Abuse Rehabilitation Facility | 3210 Eagle Run Dr Ne, Grand Rapids, MI 49525-7051 | 2019-01-29 |
| 1427283480 | West Brook Recovery Center LLC | Substance Abuse Rehabilitation Facility | 3210 Eagle Run Dr Ne, Suite 200, Grand Rapids, MI 49525-7051 | 2009-05-20 |
| 1417122631 | Clifton H Burrows | Psychologist | 3210 Eagle Run Dr Ne, Suite 200, Grand Rapids, MI 49525 | 2008-04-29 |
| 1205930344 | Norm Daniel Browe | Psychologist | 3210 Eagle Run Dr Ne, Suite 200, Grand Rapids, MI 49525 | 2006-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928507 | Therapy With Nicole Pllc | Community/Behavioral Health | 4867 E. Beltline Ave. Ne, Building #1 Lower Level, Grand Rapids, MI 49525 | 2020-09-29 |
| 1184242760 | Christian Healthcare Specialists, Inc. | Obstetrics & Gynecology | 3322 Beltline Court Ne, Suite 1, Grand Rapids, MI 49525 | 2020-07-09 |
| 1174154645 | Amy Vanderslik | Case Manager/Care Coordinator | 3310 Eaglecrest Park Dr. Ne, Suite 100, Grand Rapids, MI 49525 | 2020-02-03 |
| 1477195246 | Epic Discoveries LLC | Counselor | 4867 E. Beltline Ave Ne, Grand Rapids, MI 49525 | 2019-10-14 |
| 1598228959 | Kim Scherencel Lmsw Counseling | Social Worker | 3280 Beltline Ne, Grand Rapids, MI 49525 | 2019-04-11 |
| 1821558958 | Mindful Trajectories | Social Worker | 3280 Beltlne Ct Ne, Grand Rapids, MI 49525 | 2019-03-24 |
| 1104380518 | Julianne Lettinga, Ma Lpc Counseling | Counselor | 3280 East Beltline Ct Ne, Grand Rapids, MI 49525 | 2019-01-30 |
| 1396227229 | Christopher Scot Doucette | Social Worker | 2064 Airway St Ne, Grand Rapids, MI 49525 | 2018-09-06 |
| 1568976017 | Amy K. Deyoung, Dds, Ms, PC Pediatric Dentistry | Dentist | 3297 Eagle Run Dr. Ne, Grand Rapids, MI 49525 | 2017-11-20 |
| 1407389604 | Kelly Jo Crabb | Social Worker | 4829 E Beltline Ave Ne Ste 100, Grand Rapids, MI 49525 | 2017-04-05 |
| Find all providers in zip 49525 | ||||
| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487837506 | Pine Rest Christian Mental Health Services | Psychiatry & Neurology | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2007-12-12 |
| 1558342220 | Eric Edward Erickson | Psychiatry & Neurology | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2005-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740821339 | Farrah Laviolette | Psychiatry & Neurology | 9178 Highland Rd Ste A, White Lake, MI 48386-4619 | 2019-10-04 |
| 1427563089 | Mlrc A Medical Group PC | Psychiatry & Neurology | 26803 Ryan Rd, Warren, MI 48091-4075 | 2017-12-05 |
| 1528180841 | Michael Notorangelo | Psychiatry & Neurology | 229 E 3rd St, Harbor Springs, MI 49740 | 2007-04-06 |
| 1629120282 | Sanjeev Shanmuga Venkataraman | Psychiatry & Neurology | 4111 Andover Rd, Suite 220, Bloomfield Hills, MI 48302-1909 | 2007-01-16 |
| 1538190541 | Sunil Ramchand Rangwani | Psychiatry & Neurology | 317 E Warwick Dr, Suite B, Alma, MI 48801-1085 | 2006-07-06 |
| 1376500090 | Michael Fulton Brooks | Psychiatry & Neurology | 12851 East Grand River, Brighton Hospital, Brighton, MI 48116 | 2006-04-27 |
| 1508154626 | Lewei Lin | Psychiatry & Neurology | 4250 Plymouth Rd, Ann Arbor, MI 48109-2700 | 2011-07-11 |
| 1689907966 | Center for Behavioral Medicine Pllc | Psychiatry & Neurology | 700 S Main St, Suite 210, Lapeer, MI 48446-3077 | 2009-09-17 |
| 1174771083 | Alan Robert Teo | Psychiatry & Neurology | 4250 Plymouth Rd, Ann Arbor, MI 48109-2700 | 2008-09-04 |
| 1437318771 | Avinash Hosanagar | Psychiatry & Neurology | 2215 Fuller Rd, Ann Arbor, MI 48105-2303 | 2008-06-02 |
| Find all providers with the same taxonomy | ||||
| City | GRAND RAPIDS |
| Zip Code | 49525 |
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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.