DR. HALLIE J WILSON (NPI# 1003881053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003881053 |
| Entity Type | Individual |
| Full Name | DR. HALLIE J WILSON |
| Credential | DO |
| Practice Address |
114 N Main St Ithaca MI 48847 |
| Mailing Address |
Po Box 730 406 E Elm St Carson City MI 48811 |
| Practice Telephone | 9898754166 |
| Practice Fax Number | 9898753600 |
| Mailing Telephone | 9895843131 |
| Mailing Fax Number | 9895846734 |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5101011981 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3381288 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508117409 | Hallie Coleman Wilson | Physical Therapist | 14057 Hwy 17 N, Ste. 230, Hampstead, NC 28443 | 2012-10-02 |
| Street Address |
114 N MAIN ST |
| City | ITHACA |
| State | MI |
| Zip Code | 48847 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255680211 | Paula Lou Ellsworth | Nurse Practitioner | 114 N Main St, Ithaca, MI 48847-1132 | 2012-09-06 |
| 1316268816 | Hillary Agnes Shemes | Family Medicine | 114 N Main St, Ithaca, MI 48847-1132 | 2010-06-18 |
| 1396775318 | Edward Lewis Md PC | Surgery | 114 N Main St, Ithaca, MI 48847-1132 | 2006-07-04 |
| 1972578862 | Russell J Anderson | Family Medicine | 114 N Main St, Ithaca, MI 48847 | 2006-02-22 |
| 1801861851 | David J Freestone | Family Medicine | 114 N Main St, Ithaca, MI 48847 | 2006-02-22 |
| 1396719878 | Thomas J Knight | Physician Assistant | 114 N Main St, Ithaca, MI 48847 | 2006-02-14 |
| 1770553547 | Sparrow Carson Hospital | Clinic/Center | 114 N Main St, Ithaca, MI 48847 | 2006-01-25 |
| 1215919543 | Edward Lewis | Surgery | 114 N Main St, Ithaca, MI 48847-1132 | 2005-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164055380 | Palmer's Place Inc | Custodial Care Facility | 1009 S. St. Johns Rd, Ithaca, MI 48847 | 2020-02-17 |
| 1851656326 | Kalpesh P Lad | Pharmacist | 1010 East Center St, Ithaca, MI 48847 | 2012-07-10 |
| 1609139302 | Brian Joseph Putman | Dentist | 610 N. Pine River St., Ithaca, MI 48847 | 2012-06-19 |
| 1265544423 | John N Allen | Optometrist | 531 E Center, Ithaca, MI 48847 | 2006-08-31 |
| 1386688604 | Darren M Riopelle Dds | Dentist | 108 South Main Street, Ithaca, MI 48847 | 2006-06-16 |
| 1518933100 | Hal A Williams | Family Medicine | 114 North Main St, Ithaca, MI 48847 | 2006-02-24 |
| 1841541844 | Jenna Putman | Dentist | 610 N Pine River St, Ithaca, MI 48847 | 2012-10-01 |
| 1083903991 | Beth M Johnson | Pharmacist | 1010 East Center Street, Ithaca, MI 48847 | 2011-03-31 |
| 1245322494 | Gratiot Isabella Resd | Local Education Agency (LEA) | 1131 E. Center St., Ithaca, MI 48847-0310 | 2006-09-28 |
| 1689610040 | Audrey Ann Wendt | Counselor | 122 N Maple St, Ithaca, MI 48847-1024 | 2006-06-22 |
| Find all providers in zip 48847 | ||||
| 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 |
|---|---|---|---|---|
| 1790339406 | Isabella Citizens for Health, Inc. | Family Medicine | 400 Webster St, Ithaca, MI 48847-1818 | 2019-07-31 |
| 1548814510 | Isabella Citizens for Health, Inc. | Family Medicine | 710 N Union St, Ithaca, MI 48847-1314 | 2019-07-29 |
| 1891104899 | Nine Rivers Osteopathy PC | Family Medicine | 200 Pleasant Grove Rd Ste 6, Ithaca, NY 14850-2664 | 2014-08-05 |
| 1568742914 | Carol Thuytien Berlin | Family Medicine | 209 West State Street, Ithaca, NY 14850 | 2011-08-17 |
| 1700036654 | Susan Beith Soboroff | Family Medicine | 220 S Fulton St, Ithaca, NY 14850-3306 | 2008-09-29 |
| 1467621797 | Progressive Medicine of Ithaca, PC | Family Medicine | 402 3rd Street, Suite 2, Ithaca, NY 14850 | 2008-02-20 |
| 1619001641 | Dorothy P Ambis | Family Medicine | 208 Texas Ln, Ithaca, NY 14850-1757 | 2007-03-14 |
| 1801922919 | Marne Oshae | Family Medicine | 4 Sanctuary Dr # 2, Ithaca, NY 14850-1976 | 2007-02-25 |
| 1801981402 | Christine Vivian Lorenzo | Family Medicine | 953 Danby Road, Hammond Health Center - Ithaca College, Ithaca, NY 14850 | 2006-10-03 |
| 1487694469 | Mary Jane Welch | Family Medicine | 840 Hanshaw Road, Asthmas & Allergy Associates P.C., Ithaca, NY 14850 | 2006-06-07 |
| Find all providers in ITHACA | ||||
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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.