THOMAS GROVE WILSON (NPI# 1316495401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316495401 |
| Entity Type | Individual |
| Full Name | THOMAS GROVE WILSON |
| Credential | CNP |
| Practice Address |
3100 Kennard St Suite 100 Maplewood MN 55109-5465 |
| Practice Telephone | 6512327800 |
| Practice Fax Number | 6512327940 |
| Mailing Telephone | 6512327800 |
| Mailing Fax Number | 6512327940 |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2016-09-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
CNP 4710 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
CNP 4710 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
CNP 4710 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518287945 | Thomas A Wilson | Dentist | 149 Midland Ave, Bronxville, NY 10708-1808 | 2010-06-08 |
| 1568790186 | Thomas E. Wilson | Dentist | Bldg 128 Chaffee Rd, Us Army Dental Activit, Fort Bliss, TX 79916 | 2009-11-19 |
| 1487884375 | Thomas Joseph Wilson | Dentist | 8401 Howland Springs Rd Se, Warren, OH 44484-3120 | 2009-07-26 |
| 1891922951 | Thomas Cary Wilson | Pathology | 5330 S 900 E Ste 120, Salt Lake City, UT 84117-3504 | 2009-06-16 |
| 1609080183 | Thomas Cabell Wilson | General Practice | 323 Crescent Rd, Beckley, WV 25801 | 2007-05-10 |
| 1881817625 | Thomas Gregory Wilson | Dentist | 105 South Porter Street, Bolivar, TN 38008-1734 | 2007-04-10 |
| 1104901107 | Thomas Wayne Wilson | Dentist | 484 Jake Alexander Blvd W, Salisbury, NC 28147-1365 | 2006-10-26 |
| 1285716324 | Thomas Anthony Wilson Jr. | Counselor | 514 S Orchard St, Suite 101, Boise, ID 83705-1240 | 2006-10-19 |
| 1558443432 | Thomas E Wilson | Pathology | 1500 East Medical Center, 2nd Floor University Hospital Recp Pathology, Ann Arbor, MI 48109-5054 | 2006-10-19 |
| 1821101585 | Thomas William Wilson | Pharmacist | 7128 E Reno Ave, Suite A, Midwest City, OK 73110-4478 | 2006-08-16 |
| Street Address |
3100 KENNARD ST SUITE 100 |
| City | MAPLEWOOD |
| State | MN |
| Zip Code | 55109-5465 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598756157 | William B Hicks | Allergy & Immunology | 3100 Kennard St, Maplewood, MN 55109-5439 | 2005-11-02 |
| 1982842290 | Healtheast Care System | Non-Pharmacy Dispensing Site | 3100 Kennard St, 100, Maplewood, MN 55109-4569 | 2009-01-23 |
| 1003014911 | John Paul Berger | Internal Medicine | 3100 Kennard St, Suite 250, Maplewood, MN 55109-5465 | 2007-07-03 |
| 1770600884 | Stephanie J Fox | Allergy & Immunology | 3100 Kennard St, Maplewood, MN 55109-5465 | 2007-03-23 |
| 1902986698 | Carol Lu | Internal Medicine | 3100 Kennard St, Ste 100, Maplewood, MN 55109-5465 | 2006-10-17 |
| 1568559888 | Christopher Neville Ussher | Internal Medicine | 3100 Kennard St, Maplewood, MN 55109-5465 | 2006-10-06 |
| 1396859468 | Jeanne Mackenzie Goodspeed | Pediatrics | 3100 Kennard St, Maplewood, MN 55109 | 2006-08-18 |
| 1467497610 | Kent Davis Bergh | Family Medicine | 3100 Kennard St, Suite 100 Healtheast Physician Service, Maplewood, MN 55109 | 2006-06-19 |
| 1437198694 | Thomas G Dashiell | Internal Medicine | 3100 Kennard St, Ste 100, Maplewood, MN 55109-5465 | 2006-06-05 |
| 1073569943 | Healtheast Medical Research Institute Dba Healtheast Physician Service | Durable Medical Equipment & Medical Supplies | 3100 Kennard St, Suite 100, Maplewood, MN 55109-4569 | 2006-05-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063828 | Jodi May Begordis | Registered Nurse | 2586 7th Ave East, Suite 302, North St Paul, MN 55109 | 2020-05-06 |
| 1467917146 | Alejandro Diez Freire | Social Worker | 2468 Germain St, Maplewood, MN 55109 | 2019-02-06 |
| 1679099667 | Rochelle Marie Clarke | Registered Nurse | 2586 7th Ave East Suite 302, North Saint Paul, MN 55109 | 2017-08-21 |
| 1497298210 | Salams Care Residential, LLC | Home Health | 2240 Ide Ct, Maplewood, MN 55109 | 2016-11-28 |
| 1093199630 | Garry Allen | Psychologist | 2345 Ariel St North Mail Stop 13601a, Maplewood, MN 55109 | 2015-07-14 |
| 1700264751 | Matthew Seng Thao | Student in an Organized Health Care Education/Training Program | 1470 Gervais Ave, Maplewood, MN 55109 | 2015-05-11 |
| 1326458340 | Chong Chang | Counselor | 1705 Cope Ave E Ste I, Maplewood, MN 55109 | 2014-04-29 |
| 1619396488 | Leah Anne Downey | Occupational Therapist | 2399 Ariel St. N., Children's Theraplay, LLC, Maplewood, MN 55109 | 2014-04-09 |
| 1356765440 | Group Health Plan, Inc | Clinic/Center | 2520 12th Ave E, North St Paul, MN 55109 | 2014-02-10 |
| 1336560275 | Veneman Dental Care, Pa | Dentist | 1774 Cope Ave, Suite 110, Maplewood, MN 55109 | 2013-12-19 |
| Find all providers in zip 55109 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730578386 | Janelle Gibson | Nurse Practitioner | 2010 Springfield Ave, Maplewood, NJ 07040-2163 | 2015-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467071084 | St. Catherine University School Based Health Clinic | Nurse Practitioner | 5045 Division Ave, White Bear Lake, MN 55110 | 2020-04-14 |
| 1669005948 | Kevin Charles Carlson | Nurse Practitioner | 19303 Sorrel Ct, Corcoran, MN 55340-4447 | 2020-02-14 |
| 1144862996 | Alade Lateef Hamza | Nurse Practitioner | 4808 85th Ave N Ste 300, Brooklyn Park, MN 55443-1816 | 2019-10-14 |
| 1114584869 | Tenzin Lhamo | Nurse Practitioner | 195 Windsor Ln, New Brighton, MN 55112-3366 | 2019-05-28 |
| 1255834859 | Ashley M Morehouse | Nurse Practitioner | 625 S 4th St Ste A, Le Sueur, MN 56058-2203 | 2018-03-10 |
| 1013457381 | Lydia Nyakonu Sherman | Nurse Practitioner | 606 24th Ave S #620, Minneapolis, MN 55454 | 2017-03-06 |
| 1912447780 | Zillah Mulubisha | Nurse Practitioner | Brooklyn Park Clinic, 7650 Zane Ave N, Minneapolis, MN 55443 | 2017-02-27 |
| 1245615194 | Jennifer Nelson | Nurse Practitioner | 480 Osborne Rd Ne Ste 220, Fridley, MN 55432-2866 | 2015-07-21 |
| 1912397142 | Solomon Africanus Wesseh Jr. | Nurse Practitioner | 10135 43rd Ct Ne, Saint Michael, MN 55376-3015 | 2015-01-26 |
| 1780084004 | Angela Rae Fox | Nurse Practitioner | 7383 Upper 157th St W, Apple Valley, MN 55124-5108 | 2014-08-25 |
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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.