JODY M WILSON (NPI# 1518933290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518933290 |
| Entity Type | Individual |
| Full Name | JODY M WILSON |
| Credential | MD |
| Practice Address |
1401 E Van Buren Ave Mcalester OK 74501-4245 |
| Practice Telephone | 9184218410 |
| Practice Fax Number | 9184218772 |
| Mailing Telephone | 9184218410 |
| Mailing Fax Number | 9184218772 |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2018-11-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 25350 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 037735003 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2990 N Broadway Ave, Tyler, TX 757022149 | 9035931892 | 9035923886 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386187805 | Jody Wilson | Speech-Language Pathologist | 22 Woessner St, Pittsburgh, PA 15212-3524 | 2016-12-01 |
| 1598324493 | Jody Scott Wilson | Counselor | 81 Township Road 349, Ironton, OH 45638-8617 | 2019-06-13 |
| 1760865406 | Jody Renee Wilson | Dentist | 11711 N Pennsylvania St, Suite 114, Carmel, IN 46032-6959 | 2015-06-30 |
| 1023375177 | Jody Wilson | Social Worker | 1055 Clermont St, Department of Veterans Affairs - Va Medical Center, Denver, CO 80220-3808 | 2012-04-13 |
| Street Address |
1401 E VAN BUREN AVE |
| City | MCALESTER |
| State | OK |
| Zip Code | 74501-4245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700883261 | John Eric Raunikar | Internal Medicine | 1401 E Van Buren Ave, Mcalester, OK 74501-4245 | 2005-06-30 |
| 1063012029 | Osu Center for Health Sciences | Clinic/Center | 1401 E Van Buren Ave, Mcalester, OK 74501-4245 | 2020-10-29 |
| 1720500945 | Tilak Raj Sharma | Internal Medicine | 1401 E Van Buren Ave, Mcalester, OK 74501-4245 | 2017-07-10 |
| 1932639572 | Bradley Eric Cross | Family Medicine | 1401 E Van Buren Ave, Mcalester, OK 74501-4245 | 2017-06-15 |
| 1184087066 | Osu Center for Health Sciences | Clinic/Center | 1401 E Van Buren Ave, Mcalester, OK 74501-4245 | 2016-03-30 |
| 1730562489 | Chelsea Berges | Family Medicine | 1401 E Van Buren Ave, Mcalester, OK 74501 | 2015-06-30 |
| 1568892438 | Wanda Jean Martin | Nurse Practitioner | 1401 E Van Buren Ave, Mcalester, OK 74501 | 2013-11-13 |
| 1912334871 | Osu Center for Health Sciences | Clinic/Center | 1401 E Van Buren Ave, Mcalester, OK 74501-4245 | 2013-10-08 |
| 1407129372 | Stephenie Renee Ingram | Nurse Practitioner | 1401 E Van Buren Ave, Mcalester, OK 74501-4245 | 2012-02-22 |
| 1063790681 | Kelly Roshelle Drusen | Nurse Practitioner | 1401 E Van Buren Ave, Mcalester, OK 74501-4245 | 2011-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371466 | Belfair of Mcalester LLC | Assisted Living Facility | 802 Windsong Way, Mcalester, OK 74501 | 2019-11-22 |
| 1912425018 | Jennifer Bird | Case Manager/Care Coordinator | 34 Harpoon Dr, Mcalester, OK 74501 | 2017-09-08 |
| 1073033502 | Natalie Aline Kitchell | Case Manager/Care Coordinator | 1303 Hickory Bend, Mcalester, OK 74501 | 2017-06-26 |
| 1265964308 | Phoenix Counseling and Assessment Center, Inc. | Community/Behavioral Health | 32 E Cherokee, Suite 104, Mcalester, OK 74501 | 2017-03-29 |
| 1215302799 | Christine Herron | Physical Therapy Assistant | 1029 E. Washington Ave, Mcalester, OK 74501 | 2015-12-09 |
| 1437538212 | Lauren White | Speech-Language Pathologist | 205 South 2nd, Mcalester, OK 74501 | 2015-05-26 |
| 1316344096 | Ashley Brooke Monks | Speech-Language Pathologist | 557 Broken Feather Lane, Mcalester, OK 74501 | 2014-11-25 |
| 1821407644 | William Joseph Kinderknecht | Family Medicine | 4 E. Clark Bass Blvd., Suite 301a, Mcalester, OK 74501 | 2014-08-06 |
| 1467795153 | Kensey Mckay Holman | Occupational Therapist | 903 E Monroe Ave Ste 200, Mcalester, OK 74501 | 2013-04-01 |
| 1821334418 | Delors J Simmons | Counselor | 600 North D St, Mcalester, OK 74501 | 2012-12-31 |
| Find all providers in zip 74501 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891922670 | Misti K Crawley | Pediatrics | 1127 S George Nigh Expy, Mcalester, OK 74501-7143 | 2009-06-18 |
| 1114174588 | Mcalester Regional Hospitalist | Pediatrics | 1 E Clark Bass Blvd, Marketing Building, Mcalester, OK 74501-4209 | 2008-08-27 |
| 1700904398 | Warren Clinic Mcalester Pediatrics | Pediatrics | 1401 E Van Buren Ave, Mcalester, OK 74501-4245 | 2007-03-26 |
| 1508898404 | Maila A. Coleman | Pediatrics | 1127 S George Nigh Expy, Mcalester, OK 74501-7143 | 2006-07-07 |
| 1215967856 | Johnny Johnston | Pediatrics | 1401 E Van Buren Ave, Mcalester, OK 74501-4245 | 2006-07-03 |
| 1013970045 | Paul Stephen Thomas | Pediatrics | 1401 E Van Buren Ave, Mcalester, OK 74501-4245 | 2006-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457972366 | Saint Medical Group, LLC | Pediatrics | 3400 S Douglas Blvd Ste 307a, Oklahoma City, OK 73150-1001 | 2020-05-01 |
| 1326674177 | Premier Pediatric and Adolescent Care of Bixby | Pediatrics | 7814 E 121st St, Bixby, OK 74008 | 2020-03-12 |
| 1174180137 | Iorga Pediatrics LLC | Pediatrics | 201 N Monte Vista St Ste C, Ada, OK 74820-7220 | 2019-05-24 |
| 1851868863 | Okc Kids Urology Pllc | Pediatrics | 3705 Nw 63rd St Ste 211, Oklahoma City, OK 73116-1937 | 2018-10-28 |
| 1679067664 | Laurie Ann Alfrey | Pediatrics | 1025 E 18th St, Tulsa, OK 74120-7406 | 2018-06-21 |
| 1700380268 | Katherine Ann Brashears | Pediatrics | 6628 Fawn Canyon Dr, Oklahoma City, OK 73162-6759 | 2018-03-20 |
| 1114468436 | Vanessa Boshuizen | Pediatrics | 12020 E 31st St, Tulsa, OK 74146-2001 | 2017-03-20 |
| 1255870820 | Caitlin Schaede | Pediatrics | 601 E 13th St Ste A, Grove, OK 74344-2962 | 2017-02-15 |
| 1407390115 | Empower Pediatrics | Pediatrics | 9659 Riverside Pkwy, Tulsa, OK 74137-7398 | 2016-12-14 |
| 1528417409 | Valley Family Clinic Inc | Pediatrics | 106 Burr Ave, Pauls Valley, OK 73075-3848 | 2016-06-10 |
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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.