JONATHAN DAVID WILSON (NPI# 1841602992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841602992 |
| Entity Type | Individual |
| Full Name | JONATHAN DAVID WILSON |
| Credential | MD |
| Practice Address |
3149 Freedom Dr Charlotte NC 28208-3869 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 9803029405 |
| Mailing Telephone | 7043848680 |
| Mailing Fax Number | 7043848684 |
| Enumeration Date | 2014-05-23 |
| Last Update Date | 2020-10-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 200913 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | DEA | AC5385578-R128 | 01 |
| NC | RESIDENT TRAINING LICENSE | 200913 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 200 Greenwich Rd, Charlotte, NC 282112316 | 7044469987 | 7043501112 |
| 2225 Freedom Dr, Charlotte, NC 282081000 | 9803029000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023668019 | Jonathan Wilson | Specialist/Technologist | 1050 Union University Dr # 1811, Jackson, TN 38305-3656 | 2019-09-12 |
| 1497176903 | Jonathan Phillip Wilson | Marriage & Family Therapist | 20380 Shoshonee Rd, Apple Valley, CA 92307-5604 | 2013-12-31 |
| 1619316866 | Jonathan Adam Wilson | Dentist | 425 W Cook Rd, Mansfield, OH 44907-2300 | 2013-06-20 |
| 1760791552 | Jonathan B Wilson | Physical Therapist | 802 East Main St, Mannington, WV 26582 | 2010-09-28 |
| 1881738532 | Jonathan William Wilson | Optometrist | 1890 Goodman Rd E Ste 100, Southaven, MS 38671-9504 | 2007-02-16 |
| 1710966510 | Jonathan P Wilson | Family Medicine | 1985 Startown Rd., Fairbrock Medical Clinic Pa, Hickory, NC 28602 | 2006-01-11 |
| 1942817820 | Jonathan Harry Wilson | Technician | #1 Fifth Street, Elkins, WV 26241 | 2020-09-25 |
| 1144836610 | Jonathan Michael Wilson | Massage Therapist | 1386 Route 25a, East Setauket, NY 11733-2842 | 2020-09-21 |
| 1265079883 | Jonathan Tyler Wilson | Occupational Therapist | 711 Frankfort Rd, Shelbyville, KY 40065-9447 | 2019-12-02 |
| 1609423243 | Jonathan Wilson | Physical Therapist | 1145 Ponce De Leon Blvd, Clearwater, FL 33756-1040 | 2019-08-19 |
| Street Address |
3149 FREEDOM DR |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28208-3869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124645544 | Charlotte Sp Senior Housing Opco, LLC | Custodial Care Facility | 6041 Piedmont Row Drive, Charlotte, NC 28208 | 2020-07-01 |
| 1750929659 | Tru Pearl Solution Services Pllc | Community/Behavioral Health | 2128 Remount Road Suite B, Charlotte, NC 28208 | 2019-12-11 |
| 1245880699 | Camilla A Raley | Technician | 1539 Walton Rd, Charlotte, NC 28208 | 2019-09-18 |
| 1912567041 | Nolan Scott Blake | In Home Supportive Care | 4926 Ridgeley Dr., Suite B, Charlotte, NC 28208 | 2019-06-20 |
| 1699244145 | Catalyst Chiropractic, Pllc | Chiropractor | 2620 Tuckaseegee Rd., Charlotte, NC 28208 | 2018-11-14 |
| 1255854691 | Jessica Lynne Hunter | Social Worker | 2011 Water Walk Lane Apt 209, Charlotte, NC 28208 | 2017-07-18 |
| 1700311420 | Matthew Christian Mundorf | Chiropractor | 2620 Tuckaseegee Rd, Charlotte, NC 28208 | 2017-05-01 |
| 1700235439 | Erin Merchant | Counselor | 2016 Millerton Avenue, #2213, Charlotte, NC 28208 | 2016-06-03 |
| 1528432564 | Monika Sheree Moore | Counselor | 3205 Freedom Dr, Charlotte, NC 28208 | 2015-11-13 |
| 1205224540 | Phadality Home Care | Home Health | 201 S Hoskins Rd., Suite 119, Charlotte, NC 28208 | 2015-01-08 |
| Find all providers in zip 28208 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745985 | Alegis Care - North Carolina PC | Family Medicine | 11016 Rushmore Dr Ste 300, Charlotte, NC 28277-3651 | 2020-09-18 |
| 1902411077 | Carolina Medical Partners Pllc | Family Medicine | 10535 Flennigan Way, Charlotte, NC 28277-1417 | 2020-09-15 |
| 1083226906 | Relymd Medical Group Nc, Pllc | Family Medicine | 212 S Tryon St Ste 1000, Charlotte, NC 28281-0001 | 2020-08-21 |
| 1861019150 | Novant Medical Group, Inc. | Family Medicine | 2701 Statesville Ave., Charlotte, NC 28206 | 2020-07-02 |
| 1881223139 | Renew Health and Wellness | Family Medicine | 9010 Glenwater Dr Ste 102, Charlotte, NC 28262-8593 | 2020-04-07 |
| 1164052957 | Partners In Integrated Healthcare & Wellness Pllc | Family Medicine | 9414b Albemarle Rd, Charlotte, NC 28227-3346 | 2020-01-21 |
| 1578103636 | Madelyn Laine Eudy | Family Medicine | 15640 Don Lochman Ln Ste A, Charlotte, NC 28277-4793 | 2020-01-07 |
| 1518514686 | L'renda Arkie Adams | Family Medicine | 8724 Bodkin Ct, Charlotte, NC 28215-7356 | 2019-08-22 |
| 1952956419 | Heather Marie Anderson | Family Medicine | 6404 Albemarle Rd Ste J&k, Charlotte, NC 28212-3800 | 2019-08-01 |
| 1003460213 | Companion Health, Pllc | Family Medicine | 5029 Lady Fern Cir, Charlotte, NC 28211-4182 | 2019-07-25 |
| Find all providers in CHARLOTTE | ||||
Please comment or provide details below to improve the information on JONATHAN DAVID WILSON.
| 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.