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GREGORY J WILSON DO NPI 1669406799


NPI Information

NPI: 1669406799
Provider Name: GREGORY J WILSON, DO
Classification: Internal Medicine - 207RR0500X
Entity Type: Individual

Specialization: Rheumatology

Organization: ST LUKES CLINIC-TREASURE VALLEY LLC

PECOS Registration: Yes

Address:
520 S EAGLE RD
SUITE 3211
MERIDIAN, ID
ZIP 83642
Phone: (208) 706-5942
Get Directions

Gregory J Wilson, DO is a rheumatology internal medicine in Meridian, ID with 23 years of experience. The provider is an internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases. Gregory J Wilson, DO NPI is 1669406799. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduation Year:2001

The provider's business location address is:

520 S EAGLE RD
SUITE 3211
MERIDIAN, ID
ZIP 83642-351
Phone: (208) 706-5942

The NPI 1669406799 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/11/2006 and was last updated on 9/29/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineOS-013257PENNSYLVANIANo
2207R00000XInternal Medicine2010015957MISSOURINo
3207RR0500XInternal MedicineRheumatologyOS013257PENNSYLVANIANo
4207RR0500XInternal MedicineRheumatologyO-0777IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11669406799MEDICAIDIDAHO
2162913MEDICARE PINPENNSYLVANIA
3101334728MEDICAIDPENNSYLVANIA
420004855MEDICARE PINIDAHO
5I34280MEDICARE UPINPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.