JOAN WILSON (NPI# 1124097282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124097282 |
| Entity Type | Individual |
| Full Name | JOAN WILSON |
| Credential | MD |
| Practice Address |
2212 Wilborn Ave South Boston VA 24592-1630 |
| Mailing Address |
159 Executive Dr Ste E Danville VA 24541-4160 |
| Practice Telephone | 4345728921 |
| Practice Fax Number | 4345722063 |
| Mailing Telephone | 4345728921 |
| Mailing Fax Number | 4345722063 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2018-02-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 0101034828 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 006207561 | 05 | |
| VA | BCBS | 240940 | 01 |
| VA | OPTIMA | 48092 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457902629 | Joan Geraldene Wilson | Licensed Practical Nurse | 4046 Lowerre Pl, Bronx, NY 10466-3908 | 2019-09-27 |
| 1780807784 | Joan Alice Wilson | Registered Nurse | 400 S 6th Ave, Yuma, AZ 85364-2127 | 2007-04-10 |
| 1992875496 | Joan Wilson | Social Worker | 2810 Mount Hope Rd, Webb City, MO 64870-9674 | 2006-11-09 |
| 1770984890 | Joan Wilson | Nurse Practitioner | 1530 3rd Ave S, Tht 422, Birmingham, AL 35294-0006 | 2014-09-08 |
| 1104067396 | Joan Esse Wilson | Speech-Language Pathologist | 4801 Lang Ave Ne Ste 110, Albuquerque, NM 87109-4475 | 2009-03-17 |
| 1568611200 | Joan M Wilson | Registered Nurse | 100 Benchley Pl, Apt 3c, Bronx, NY 10475-3302 | 2008-09-18 |
| 1619133626 | Joan Wilson | Audiologist | 901 Hampton Blvd, Norfolk, VA 23507-1503 | 2008-07-30 |
| 1639298466 | Joan Wilson | Registered Nurse | 13 Prospect St, Greenfield, MA 01301-3506 | 2007-03-29 |
| 1447328661 | Joan Lynne Wilson | Social Worker | 9040a Fitzsimmons Dr, Madigan Army Medical Center, Tacoma, WA 98431-1100 | 2006-12-04 |
| Street Address |
2212 WILBORN AVE |
| City | SOUTH BOSTON |
| State | VA |
| Zip Code | 24592-1630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861472524 | Nonna Lyn M Ebalo | Pediatrics | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2006-01-19 |
| 1366814113 | Fuller Roberts Ob-gyn and Primary Care | Obstetrics & Gynecology | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2015-10-20 |
| 1316320187 | Cynthia Blanks Cole | Nurse Practitioner | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2015-06-29 |
| 1255771770 | Dominion Health Medical Assoc. | Clinic/Center | 2212 Wilborn Ave, South Boston, VA 24592 | 2013-06-28 |
| 1346553468 | Michelle Wilkens Helms | Specialist | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2010-07-18 |
| 1659317576 | Duc K Trieu | Obstetrics & Gynecology | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2006-06-20 |
| 1407891815 | Fuller-roberts Clinic, Inc | Pediatrics | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2006-06-19 |
| 1932178019 | Pamela Reynolds | Nurse Practitioner | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2006-03-14 |
| 1225006489 | William Allen Fuller Jr. | Surgery | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2006-03-14 |
| 1427026806 | Prasit Thanaporn | Obstetrics & Gynecology | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2006-03-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154966398 | Transformations Center for Health Wellness LLC | Counselor | 2170 Sandy Beach Road, South Boston, VA 24592 | 2019-11-12 |
| 1740830215 | Kirstyn Lokker | Occupational Therapist | 1 High School Circle, South Boston, South Boston, VA 24592 | 2019-09-17 |
| 1841764248 | Nicole Ivey | Occupational Therapy Assistant | 103 Rosehil Rd, South Boston, VA 24592 | 2019-01-18 |
| 1841700960 | Bio-medical Applications of Virginia, Inc. | Clinic/Center | 130 Aubreys Loop, South Boston, VA 24592 | 2017-10-03 |
| 1659828820 | Family Preservation Services, Inc | Community/Behavioral Health | 1 High School Circle, South Boston, VA 24592 | 2016-09-06 |
| 1316222821 | Family and Children Enrichment Services Inc. | Health Maintenance Organization | 220 Paradise Lane, South Boston, VA 24592 | 2011-10-15 |
| 1326365578 | Brinda Howard | Nurse's Aide | 104 Love Shop Park Rd Lot #25, South Boston, VA 24592 | 2010-04-28 |
| 1356513543 | Betts Medical Supplies, LLC. | Durable Medical Equipment & Medical Supplies | 403 Factory Street, Suite B, South Boston, VA 24592 | 2008-03-27 |
| 1407051873 | Dominion Health Medical Assoc | Legal Medicine | 101 Aubrey's Loop Rd, South Boston, VA 24592 | 2007-06-18 |
| 1437352945 | Behavioral Health Associates, Inc. | Non-emergency Medical Transport (VAN) | 515 Yancey Ave, South Boston, VA 24592 | 2007-06-11 |
| Find all providers in zip 24592 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366814113 | Fuller Roberts Ob-gyn and Primary Care | Obstetrics & Gynecology | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2015-10-20 |
| 1215294814 | Joni Abbott | Obstetrics & Gynecology | 2206 Wilborn Ave, South Boston, VA 24592-1630 | 2012-04-19 |
| 1659317576 | Duc K Trieu | Obstetrics & Gynecology | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2006-06-20 |
| 1427026806 | Prasit Thanaporn | Obstetrics & Gynecology | 2212 Wilborn Ave, South Boston, VA 24592-1630 | 2006-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093324162 | Evoscient Gynecology Center for Pelvic Health and Surgery, PC | Obstetrics & Gynecology | 108 Independence Blvd, Suite 162, Virginia Beach, VA 23455 | 2020-07-24 |
| 1205493129 | Meredith Hooover | Obstetrics & Gynecology | 3300 Gallows Rd Falls Church, Va 22042 - 3307, Arlington, VA 22042 | 2019-05-27 |
| 1083103592 | Premier Ob/gyn Associates LLC | Obstetrics & Gynecology | 3700 Joseph Siewick Dr Ste 102, Fairfax, VA 22033-1737 | 2018-05-09 |
| 1659876530 | Cassandra Lyn Presti | Obstetrics & Gynecology | 3300 Gallows Rd Fl 2, Falls Church, VA 22042 | 2018-03-24 |
| 1215439526 | Women's Choice Obgyn LLC | Obstetrics & Gynecology | 10875 Main St Ste 210, Fairfax, VA 22030-4732 | 2018-03-02 |
| 1871019323 | Ntmt Group | Obstetrics & Gynecology | 8301 Arlington Blvd Ste 206, Fairfax, VA 22031-2902 | 2017-08-16 |
| 1376071951 | Mid-atlantic Womens Care Plc | Obstetrics & Gynecology | 11747 Jefferson Ave Ste 1a, Newport News, VA 23606-4401 | 2017-05-26 |
| 1902339401 | Jerrid Neeley | Obstetrics & Gynecology | 7547 Medical Dr Ste 1200, Gloucester, VA 23061-4351 | 2017-04-11 |
| 1396298873 | Mid-atlantic Womens Care Plc | Obstetrics & Gynecology | 6353 Center Dr Ste 100, Norfolk, VA 23502-4100 | 2016-08-01 |
| 1750731063 | Rachel Bridge | Obstetrics & Gynecology | 3023 Hamaker Ct Ste 210, Fairfax, VA 22031-2240 | 2016-06-16 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BOSTON |
| Zip Code | 24592 |
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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.