DR. CARL WILSON (NPI# 1033110465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033110465 |
| Entity Type | Individual |
| Full Name | DR. CARL WILSON |
| Credential | MD |
| Practice Address |
435 Doyle Park Dr Santa Rosa CA 95405-4515 |
| Practice Telephone | 7075279510 |
| Practice Fax Number | 7075271306 |
| Mailing Telephone | 7075279510 |
| Mailing Fax Number | 7075271306 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2017-07-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
G44318 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G443180 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124645932 | Carl Wilson | Massage Therapist | 12345 Roosevelt Way Ne Apt 304, Seattle, WA 98125-4867 | 2020-06-26 |
| 1932419298 | Carl T. Wilson | Registered Nurse | 89 Old Post Rd, Marlboro, NY 12542-6544 | 2010-10-20 |
| 1386147957 | Carl Wilson | Physician Assistant | 150 Dennis St Sw, Ste A, Tumwater, WA 98501-5459 | 2018-03-09 |
| 1841658754 | Carl Michael Wilson Jr. | Counselor | 110 Boston St, Salem, MA 01970-1402 | 2016-02-05 |
| 1558621854 | Carl Wilson | Home Health Aide | 5513 Illinois Ave Nw, Washington, DC 20011-2937 | 2012-05-21 |
| 1467731158 | Carl Wilson | Counselor | 1201 S Proctor St, Tacoma, WA 98405-2047 | 2011-08-11 |
| 1073608659 | Carl Thayne Wilson | Anesthesiology | 1034 North 500 West, Utah Valley Regional Medical Center, Provo, UT 84604 | 2006-10-03 |
| 1851319198 | Carl Wilson | Orthopaedic Surgery | 2016 Bronxdale Ave, Bronx, NY 10462-3388 | 2006-07-17 |
| Street Address |
435 DOYLE PARK DR |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95405-4515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316459407 | Simy Suresh Antony | Nurse Practitioner | 435 Doyle Park Dr, Santa Rosa, CA 95405-4515 | 2017-10-29 |
| 1093169815 | Santa Rosa Kidney Care PC | Internal Medicine | 435 Doyle Park Dr, Santa Rosa, CA 95405-4515 | 2016-04-18 |
| 1881068443 | Fmcps Santa Rosa LLC | Internal Medicine | 435 Doyle Park Dr, Santa Rosa, CA 95405-4515 | 2015-11-19 |
| 1255323325 | Carl Wilson Md Inc & Jill Edison Md | Internal Medicine | 435 Doyle Park Dr, Santa Rosa, CA 95405-4515 | 2005-08-16 |
| 1225039514 | Jill Elizabeth Edison | Internal Medicine | 435 Doyle Park Dr, Santa Rosa, CA 95405-4515 | 2005-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230486 | Lizett Camacho | Counselor | 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 | 2020-06-22 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1306246772 | Kirsten Eckert | Advanced Practice Midwife | 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 | 2014-09-03 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1851631642 | Debi M. Emmons | Marriage & Family Therapist | 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 | 2013-02-15 |
| 1841549979 | Karie Louise Klim | Marriage & Family Therapist | 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 | 2012-09-05 |
| 1427314400 | Rachel E. Page | Counselor | 2447 Summerfield Rd., Santa Rosa, CA 95405 | 2012-04-04 |
| 1689991572 | Center for Integral Healing Inc. | Community Health Worker | 182 Farmers Lane, #203, Santa Rosa, CA 95405 | 2010-04-30 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| Find all providers in zip 95405 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437380987 | Sandra Barrow | Internal Medicine | 2301 Circadian Way Ste A, Santa Rosa, CA 95407-5457 | 2009-07-31 |
| 1093169815 | Santa Rosa Kidney Care PC | Internal Medicine | 435 Doyle Park Dr, Santa Rosa, CA 95405-4515 | 2016-04-18 |
| 1881068443 | Fmcps Santa Rosa LLC | Internal Medicine | 435 Doyle Park Dr, Santa Rosa, CA 95405-4515 | 2015-11-19 |
| 1255323325 | Carl Wilson Md Inc & Jill Edison Md | Internal Medicine | 435 Doyle Park Dr, Santa Rosa, CA 95405-4515 | 2005-08-16 |
| 1225039514 | Jill Elizabeth Edison | Internal Medicine | 435 Doyle Park Dr, Santa Rosa, CA 95405-4515 | 2005-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710585328 | Empire Medical Specialist | Internal Medicine | 28625 Quaint St, Agoura Hills, CA 91301-1735 | 2020-10-15 |
| 1538774989 | Modern Telehealth | Internal Medicine | 1509 Espinosa Cir, Palos Verdes Estates, CA 90274-1917 | 2020-09-12 |
| 1073137733 | Jafar Alsaid | Internal Medicine | 2009 Baywood Ln, Davis, CA 95618-0500 | 2020-05-29 |
| 1164041422 | Advanced Care Multispecialty Medical Group Apc | Internal Medicine | 13990 Bear Fence Court, Moorpark, CA 93021-5022 | 2020-04-15 |
| 1629600416 | Valley Kidney Medical Group Inc | Internal Medicine | 1646 E Herndon Ave Ste 106, Fresno, CA 93720-3380 | 2020-02-10 |
| 1437789278 | Spectrum Dialysis | Internal Medicine | 18040 Sherman Way Ste 220, Reseda, CA 91335-4631 | 2020-01-21 |
| 1932745007 | K Care Ipa | Internal Medicine | 18000 Studebaker Rd Ste 100, Cerritos, CA 90703-7929 | 2019-11-22 |
| 1326609496 | Alliance Hospitalist Medical Corporation | Internal Medicine | 3300 E South St Ste 307, Lakewood, CA 90805 | 2019-06-27 |
| 1669930723 | Adventist Health Physicians Network | Internal Medicine | 111 Raley Blvd Ste 160, Chico, CA 95928-8351 | 2019-03-07 |
| 1295293363 | Adventist Health Physicians Network | Internal Medicine | 111 Raley Blvd Ste 220, Chico, CA 95928-8351 | 2019-03-07 |
| Find all providers with the same taxonomy | ||||
| City | SANTA ROSA |
| Zip Code | 95405 |
Please comment or provide details below to improve the information on DR. CARL 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.