THOMAS J WILSON (NPI# 1689788655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689788655 |
| Entity Type | Individual |
| Full Name | THOMAS J WILSON |
| Credential | MD |
| Practice Address |
625 East Broadway St Johns Medical Center Dept of Radiology Jackson WY 83001 |
| Mailing Address |
Po Box 9230 Jackson WY 83002-9230 |
| Practice Telephone | 8006331905 |
| Practice Fax Number | 9134910411 |
| Mailing Telephone | 8006331905 |
| Mailing Fax Number | 9134910411 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2007-11-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
5596A | WY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | MEDICAL LICENSE | 5596A | 01 |
| DEA | AW7327528 | 01 | |
| WYOMING BLUE | 313044 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518287945 | Thomas A Wilson | Dentist | 149 Midland Ave, Bronxville, NY 10708-1808 | 2010-06-08 |
| 1568790186 | Thomas E. Wilson | Dentist | Bldg 128 Chaffee Rd, Us Army Dental Activit, Fort Bliss, TX 79916 | 2009-11-19 |
| 1487884375 | Thomas Joseph Wilson | Dentist | 8401 Howland Springs Rd Se, Warren, OH 44484-3120 | 2009-07-26 |
| 1891922951 | Thomas Cary Wilson | Pathology | 5330 S 900 E Ste 120, Salt Lake City, UT 84117-3504 | 2009-06-16 |
| 1609080183 | Thomas Cabell Wilson | General Practice | 323 Crescent Rd, Beckley, WV 25801 | 2007-05-10 |
| 1881817625 | Thomas Gregory Wilson | Dentist | 105 South Porter Street, Bolivar, TN 38008-1734 | 2007-04-10 |
| 1104901107 | Thomas Wayne Wilson | Dentist | 484 Jake Alexander Blvd W, Salisbury, NC 28147-1365 | 2006-10-26 |
| 1285716324 | Thomas Anthony Wilson Jr. | Counselor | 514 S Orchard St, Suite 101, Boise, ID 83705-1240 | 2006-10-19 |
| 1558443432 | Thomas E Wilson | Pathology | 1500 East Medical Center, 2nd Floor University Hospital Recp Pathology, Ann Arbor, MI 48109-5054 | 2006-10-19 |
| 1821101585 | Thomas William Wilson | Pharmacist | 7128 E Reno Ave, Suite A, Midwest City, OK 73110-4478 | 2006-08-16 |
| Street Address |
625 EAST BROADWAY ST JOHNS MEDICAL CENTER DEPT OF RADIOLOGY |
| City | JACKSON |
| State | WY |
| Zip Code | 83001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316979057 | William David Hamilton | Nurse Anesthetist, Certified Registered | 625 East Broadway, Jackson, WY 83001 | 2006-07-06 |
| 1881896694 | Teton County Hospital District | General Acute Care Hospital | 625 East Broadway, Jackson, WY 83001 | 2007-06-04 |
| 1215064985 | Teton County Hospital District | Skilled Nursing Facility | 625 East Broadway, Jackson, WY 83001-8642 | 2007-02-28 |
| 1700990777 | Robert C Berlin | Radiology | 625 East Broadway, St Johns Medical Center Dept of Radiology, Jackson, WY 83001 | 2006-08-18 |
| 1417061482 | Christopher Sean Haling | Radiology | 625 East Broadway, St Johns Medical Center Dept of Radiology, Jackson, WY 83001 | 2006-08-18 |
| 1952317323 | Gary W Heath | Radiology | 625 East Broadway, St Johns Medical Center Dept of Radiology, Jackson, WY 83001 | 2006-07-31 |
| 1184656191 | Jean Ann Hamilton | Nurse Anesthetist, Certified Registered | 625 East Broadway, Jackson, WY 83001 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861006108 | Anne Kathleen Milburn | Physical Therapist | 3620 S Park Drive, Jackson, WY 83001 | 2020-09-03 |
| 1568009637 | Katherine Pringle Ford | Case Manager/Care Coordinator | 2065 E. Limber Pine Road, Jackson, WY 83001 | 2019-12-07 |
| 1043878408 | Cossette Burnham | Physical Therapist | Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 | 2019-05-31 |
| 1982169371 | Cynthia Buck Huyffer | Social Worker | 755a Cache Creek Drive, Jackson, WY 83001 | 2019-02-10 |
| 1093281594 | Lara Cilo | Speech-Language Pathologist | 1300 W. Valley Springs Road, Jackson, WY 83001 | 2018-10-23 |
| 1740776202 | Teton Oral and Maxillofacial Surgery | Dentist | 1160 Alpine Ln Ste 1d, Jackson, WY 83001 | 2018-07-09 |
| 1437642055 | Anna Yanchek | Physical Therapist | 1090 Us- 89, Jackson Hole, WY 83001 | 2018-06-08 |
| 1891200762 | Tyler Ross Wright | Chiropractor | 1325 Us-89, Suite 108, Jackson, WY 83001 | 2017-12-13 |
| 1073027280 | Root To Rise Counseling and Consulting, Pllc | Social Worker | 2033 Dandelion Court, Jackson, WY 83001 | 2017-11-27 |
| 1962923912 | Piper Worthington | Social Worker | 1910 High School Rd, Jackson, WY 83001 | 2017-06-29 |
| Find all providers in zip 83001 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063890754 | Phil Otis Nelson Jr. | Radiology | 146 Ridge Dr, Jackson, MS 39216-4109 | 2015-05-13 |
| 1891030946 | Cherry Hill Radiology Pllc | Radiology | 401 Redfield Dr, Jackson, TN 38305-8555 | 2012-11-30 |
| 1245414275 | Breathit County Imaging Center | Radiology | 1389 Ky Hwy 15 North, St. John Newmans Medical Plaza, Jackson, KY 41339 | 2007-12-27 |
| 1407933930 | Karen Collette Jensen | Radiology | 14 Adams Road, Jackson, NH 03846 | 2006-11-01 |
| 1770676801 | Gerald O Daniel | Radiology | 708 W Forest Avenue, Jackson, TN 38301 | 2006-10-02 |
| 1497761837 | Arlin George Hatfield IIi | Radiology | 1405 North State Street, Suite 200, Jackson, MS 39202 | 2006-07-31 |
| 1225083942 | Robert Houston Hardin Jr. | Radiology | 2210 Heritage Hill Dr, Jackson, MS 39211-5821 | 2006-05-23 |
| 1881655967 | Jane Warne Brown | Radiology | 91 Stonehaven Cir, Jackson, TN 38305-1945 | 2006-03-29 |
| 1780645028 | Andrew Laurence Rivard | Radiology | 2500 State Street, University of Mississippi Medical Center, Jackson, MS 39216 | 2006-03-28 |
| 1013985134 | John A. Sullivan | Radiology | 7330 Ryegrass Road, Jackson, WY 83001 | 2006-03-14 |
| Find all providers in JACKSON | ||||
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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.