DERRON WILSON (NPI# 1780669267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780669267 |
| Entity Type | Individual |
| Full Name | DERRON WILSON |
| Credential | MD |
| Practice Address |
8333 Naab Rd Suite 250 Indianapolis IN 46260-5924 |
| Practice Telephone | 3173961300 |
| Practice Fax Number | 3178764070 |
| Mailing Telephone | 3173961300 |
| Mailing Fax Number | 3178764070 |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2014-02-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
01047150A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200313770B | 05 |
| Street Address |
8333 NAAB RD SUITE 250 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46260-5924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235131103 | Ronald L Young II | Neurological Surgery | 8333 Naab Rd, 250, Indianapolis, IN 46260-5924 | 2005-08-11 |
| 1699318592 | Marcy Penrod | Nurse Practitioner | 8333 Naab Rd, Indianapolis, IN 46260-5924 | 2019-10-23 |
| 1922471986 | Katherine Deines | Registered Nurse | 8333 Naab Rd, #250, Indianapolis, IN 46260-5924 | 2015-11-12 |
| 1487097994 | Priority Physicians, PC | Clinic/Center | 8333 Naab Rd, Suite 360, Indianapolis, IN 46260-5924 | 2013-04-15 |
| 1043552102 | Indiana Neuroscience Associates | Psychiatry & Neurology | 8333 Naab Rd, Ste 260, Indianapolis, IN 46260-5924 | 2013-03-26 |
| 1346588688 | St. Vincent Health Wellness and Preventive Care Institute, Inc. | Internal Medicine | 8333 Naab Rd, Suite 301, Indianapolis, IN 46260-5924 | 2013-01-22 |
| 1962753525 | Libby Deann Reese | Registered Nurse | 8333 Naab Rd, Suite 250, Indianapolis, IN 46260-5924 | 2012-09-24 |
| 1770832586 | Hadi S Tolooi | Psychiatry & Neurology | 8333 Naab Rd, Ste 260, Indianapolis, IN 46260-5924 | 2012-09-07 |
| 1659620532 | Basem Kayali | Hospitalist | 8333 Naab Rd, Ste 400, Indianapolis, IN 46260-5924 | 2012-09-06 |
| 1619288560 | Kristin Ann Halpern | Physician Assistant | 8333 Naab Rd, Suite 250, Indianapolis, IN 46260-5924 | 2010-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508478298 | Verity Smile Studio, LLC | Clinic/Center | 1619 W. 86th St Suite B, Indianapolis, IN 46260 | 2020-08-23 |
| 1225666589 | Alexander Michael Kiel | Student in an Organized Health Care Education/Training Program | Internal Medicine 3 North, 2001 W. 86th Street, Indianapolis, IN 46260 | 2020-03-31 |
| 1043793151 | Lisa R Foreman | Registered Nurse | 1389 W. 86th Street Unit # 238, Indianapolis, IN 46260 | 2018-09-13 |
| 1790268399 | Esther Muturi | Chore Provider | 1214 Racquetclub South Drive Apt C, Indianapolis, IN 46260 | 2018-09-10 |
| 1912483215 | Katherine Donnelly | Community Health Worker | 1612 Lancashire Ct, Indianapolis, IN 46260 | 2018-07-19 |
| 1326539628 | Peaceful Source Midwifery LLC | Advanced Practice Midwife | 1139 Canterbury Ct., Unit B, Indianapolis, IN 46260 | 2018-05-22 |
| 1144722695 | Mindful Services Center LLC | Clinic/Center | 9002 N Meridian St, Ste 200, Indianapolis, IN 46260 | 2018-03-01 |
| 1144731910 | Meenu Jain | Student in an Organized Health Care Education/Training Program | Internal Medicine, 8414 Naab Road, Suite 100, Indianapolis, IN 46260 | 2017-10-19 |
| 1609392422 | 1717 Senior Living, LLC | Assisted Living Facility | 1703 West 86th Street, Indianapolis, IN 46260 | 2017-08-15 |
| 1093246985 | Royalty Transports LLC | Bus | 2255 W. 67th St., Indianapolis, IN 46260 | 2017-03-23 |
| Find all providers in zip 46260 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972590529 | Edward J Kowlowitz | Anesthesiology | 8805 N Meridian St, Indianapolis, IN 46260-2332 | 2005-09-29 |
| 1326040254 | John Barnett Swofford | Anesthesiology | 5445 E 16th St, Indianapolis, IN 46218-4869 | 2005-08-11 |
| 1629075080 | Charles R Smith | Anesthesiology | 8450 Northwest Blvd., Indianapolis, IN 46278-1381 | 2005-06-30 |
| 1295154110 | Sydney Harman | Anesthesiology | 201 Pennsylvania Pkwy Ste 100, Indianapolis, IN 46280 | 2014-04-08 |
| 1326472259 | I. C. Pain Solutions, PC | Anesthesiology | 6325 S East St, Indianapolis, IN 46227-7110 | 2013-08-27 |
| 1760724603 | David Michael Gordon | Anesthesiology | 8805 N Meridian St, Indianapolis, IN 46260 | 2013-03-18 |
| 1356506281 | Jwm Neurology PC | Anesthesiology | 8040 Clearvista Pkwy, Suite 440, Indianapolis, IN 46256-5630 | 2008-07-21 |
| 1447356704 | Jocelyn L. Bush | Anesthesiology | 8805 N Meridian St, Indianapolis, IN 46260-2760 | 2006-09-15 |
| 1700815610 | Troy Glenn Pfefferkorn | Anesthesiology | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2006-07-02 |
| 1982646592 | Sanjay B Kuber | Anesthesiology | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2006-06-11 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46260 |
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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.