MR. JAMES DOUGLAS WILSON (NPI# 1255344396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255344396 |
| Entity Type | Individual |
| Full Name | MR. JAMES DOUGLAS WILSON |
| Credential | LCSW |
| Practice Address |
607 Baxter St Fairview Associates Johnson City TN 37601 |
| Mailing Address |
Po Box 9054 Gray TN 37615-9054 |
| Practice Telephone | 4232322720 |
| Practice Fax Number | 4239280381 |
| Mailing Telephone | 4234673600 |
| Mailing Fax Number | 4234673696 |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 104100000X | Social Worker | LCSW709 | TN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UBH SENIOR | 33476 | 01 | |
| MAGELLAN PINNACLE | 0128301 | 01 | |
| UBH EMPLOYER | 33476 | 01 | |
| MAGELLAN EAP | 0128301 | 01 | |
| VALUEOPTIONS GROUP | 334969 | 01 | |
| MAGELLAN NAVIGATOR | 0128301 | 01 | |
| VALUEOPTIONS | 104224 | 01 | |
| CIGNA MCC | 55538 | 01 | |
| MAGELLAN SUMMIT | 0128301 | 01 | |
| FIRST HEALTH | 1046524 | 01 | |
| ANTHEM PROF TRIGON | 189387 FVJC | 01 | |
| UBH HEALTHPLAN | 33476 | 01 | |
| ANTHEM PREF TRIGON | 189387 FVJC | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992369102 | James Wilson | Assisted Living Facility | 15986 W Main St, Louisville, MS 39339-2636 | 2019-04-24 |
| 1841778735 | James Wilson | Contractor | 827 Highway 82 W, Greenville, MS 38701-5715 | 2018-08-01 |
| 1396246617 | James Wilson | Home Health Aide | 2052 Miles Woods Dr, Cincinnati, OH 45231-2150 | 2018-02-22 |
| 1942712781 | James Wilson | Technician | 41 Underwood St Nw, Washington, DC 20012-2115 | 2017-11-02 |
| 1366992158 | James Earl Wilson | Licensed Practical Nurse | 62 W Garden Dr, Rochester, NY 14606-4707 | 2016-10-05 |
| 1013463520 | James Wilson | Specialist/Technologist | 2117 Franklin Dr, North Augusta, SC 29841-9263 | 2016-08-26 |
| 1013360270 | James Wilson | Specialist/Technologist | 1001 E Fm 2410 Rd, Harker Heights, TX 76548-6845 | 2016-07-22 |
| 1134516644 | James Wilson | Occupational Therapy Assistant | 3903 Whirlwind St, Bryant, AR 72022-6710 | 2015-04-22 |
| 1205268000 | James William Wilson | Massage Therapist | 8219 River Country Dr, Weeki Wachee, FL 34607-2137 | 2013-08-02 |
| 1083050850 | James R Wilson | Physical Medicine & Rehabilitation | 4229 Pearl Rd # N2.42, Cleveland, OH 44109-4218 | 2013-05-20 |
| Street Address |
607 BAXTER ST FAIRVIEW ASSOCIATES |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326223488 | Kelly Suzanne Hensley | Case Manager/Care Coordinator | 607 Baxter St, Johnson City, TN 37601-4003 | 2008-01-08 |
| 1427187947 | Randall Edward Jessee | Counselor | 607 Baxter St, Fairview Associates, Johnson City, TN 37604 | 2007-03-02 |
| 1407994163 | Rhonda Faye Marshall | Registered Nurse | 607 Baxter St, Johnson City, TN 37601 | 2007-02-02 |
| 1134282551 | Frontier Health | Clinic/Center | 607 Baxter St, Johnson City, TN 37601-4003 | 2006-12-18 |
| 1245305481 | Sarah Katherine Henley | Psychologist | 607 Baxter St, Johnson City, TN 37604 | 2006-11-22 |
| 1396857322 | Diane Louise Whitehead | Psychologist | 607 Baxter St, Fairview Ass., Johnson City, TN 37601 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396381992 | Juan Carlos Simon Villegas Gomez | Specialist/Technologist | 1081 John Robert Bell Dr, Johnson City, TN 37601 | 2019-11-19 |
| 1629537279 | Jaima Suzanne Price | Hearing Instrument Specialist | 106 E Watauga Avenue, Johnson City, TN 37601 | 2019-03-13 |
| 1275004467 | Brittany Howell | Speech-Language Pathologist | 2114 E. Fairview Ave, Johnson City, TN 37601 | 2018-12-16 |
| 1194229948 | Heather Chantel Lester | Physical Therapist | 2114 E. Fairview Avenue, Johnson City, TN 37601 | 2018-03-19 |
| 1477061869 | Patrick Conway Reynolds | Specialist/Technologist | 1081 John Robert Bell Drive, Johnson City, TN 37601 | 2018-01-19 |
| 1790201135 | Surgical Services of East Tennessee PC | Surgery | 300 East Main St., Suite 301, Johnson City, TN 37601 | 2017-08-17 |
| 1073065694 | Davina Leah Reppond | Home Health | 1204 E Myrtle Ave, Johnsoncity, TN 37601 | 2016-10-31 |
| 1003365503 | Wendi Y Minutolo | Behavioral Analyst | 403 Princeton Rd Ste 3, Johnson City, TN 37601 | 2016-09-25 |
| 1306208798 | Rachel Anne Anderson | Nurse Practitioner | 1118 East Holston Avenue, Johnson City, TN 37601 | 2016-03-24 |
| 1932560976 | Kaydee Louise Davidson | Occupational Therapist | 3209 Bristol Highway, Johnson City, TN 37601 | 2016-03-18 |
| Find all providers in zip 37601 | ||||
| Taxonomy Code | 104100000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. |
| Notes: Source: National Association of Social Workers, 2009 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082855 | Genessa Roberts | Social Worker | 3211 N Roan St, Johnson City, TN 37601-1213 | 2020-08-03 |
| 1265973531 | Abbey C Pelot | Social Worker | 139 Grand Ave, Johnson City, NY 13790-1675 | 2017-03-20 |
| 1215332507 | Alice Sounthala | Social Worker | 31 Avon St, Johnson City, NY 13790-1701 | 2014-10-29 |
| 1497178289 | Robin Marie Ledford | Social Worker | 2408 Susannah Street, Johnson City, TN 37601 | 2014-01-29 |
| 1134565765 | Kimberly Lynn Simerly | Social Worker | 1109 Skyline Dr Apt 4, Johnson City, TN 37604-3777 | 2013-05-22 |
| 1346540689 | Robin Hager Potter | Social Worker | 1507 E 11th Ave, Johnson City, TN 37601-2720 | 2010-11-02 |
| 1013245497 | Kemper Scott Rasnake | Social Worker | 1615 W Market St Ste A, Johnson City, TN 37604-4904 | 2009-11-24 |
| 1972740512 | Julia Shawn Swink | Social Worker | 2208 Marion Dr, Johnson City, TN 37601-9288 | 2009-01-20 |
| 1497957989 | David J Clovsky | Social Worker | 270 Riverside Drive #201, Johnson City, NY 13790-2741 | 2007-06-05 |
| 1689714651 | Kristen Mir | Social Worker | 2514 1/2 Wesley St Ste 2, Johnson City, TN 37601-1754 | 2007-02-07 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37601 |
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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.