ROBERT WILSON, DC, PLLC (NPI# 1366957656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366957656 |
| Entity Type | Organization |
| Organization Name | ROBERT WILSON, DC, PLLC |
| Other Organization Name | LIFE SOURCE OF CENTERVILLE |
| Practice Address |
132a N Central Ave Centerville TN 37033 |
| Mailing Address |
Po Box 99 Centerville TN 37033-0099 |
| Practice Telephone | 9317294001 |
| Practice Fax Number | 9317294081 |
| Mailing Telephone | 9317294001 |
| Mailing Fax Number | 9317294081 |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2018-06-11 |
| Authorized Official Name | DR. ROBERT E WILSON (SOLE OWNER) |
| Authorized Official Telephone | 9317294001 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS BLUE SHIED OF TENNESSEE | 6128617 | 01 | |
| NPPES - INDIVIDUAL NPI | 1144589458 | 01 |
| Other Name | Type Code |
|---|---|
| Life Source of Centerville | Doing Business As Name - Organization |
| Street Address |
132A N CENTRAL AVE |
| City | CENTERVILLE |
| State | TN |
| Zip Code | 37033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144589458 | Robert Wilson | Chiropractor | 132a N Central Ave, Centerville, TN 37033 | 2012-05-07 |
| 1083967251 | Scott F Jutte Dc PC | Chiropractor | 132a N Central Ave, Centerville, TN 37033-1427 | 2012-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225550031 | Saint Thomas Health | Pharmacy | 150 East Swan Street, Centerville, TN 37033 | 2017-07-13 |
| 1558726109 | Rebecca Schmid | Nurse Practitioner | 1518 Hwy 100, Centerville, TN 37033 | 2015-12-28 |
| 1053543256 | Sandra Elliott Tinnin | Midwife | 1180 Sulpher Creek Rd., Centerville, TN 37033 | 2009-08-20 |
| 1225267578 | Charlotte Maricia Staggs | Counselor | 820 Highway 100, #3, Centerville, TN 37033 | 2009-07-08 |
| 1083742084 | Centerstone | Community/Behavioral Health | 704 Highway 100, Suite101, Centerville, TN 37033 | 2007-03-01 |
| 1972684074 | Christy Hulan Mays | Pharmacist | 401 West Public Square, Centerville, TN 37033 | 2006-10-17 |
| 1992718688 | Saint Thomas Hickman Hospital | Clinic/Center | 150 E Swan Street, Centerville, TN 37033 | 2006-08-14 |
| 1528090552 | Freds Stores of Tennessee Inc | Durable Medical Equipment & Medical Supplies | 1797 Hwy 100 East, Centerville, TN 37033 | 2006-07-07 |
| 1326074402 | Centerville Medical Investors, LLC | Skilled Nursing Facility | 112 Old Dickson Road, Centerville, TN 37033 | 2006-06-23 |
| 1649251299 | County of Hickman Office of County Executive | Ambulance | 106 E. Swan St, Centerville, TN 37033 | 2005-11-10 |
| Find all providers in zip 37033 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932503299 | Elite Personal Care Inc. | Clinic/Center | 814 Carl Vinson Pkwy, Centerville, GA 31028-1421 | 2014-10-15 |
| 1629234950 | Adkins Family Chiropractic, LLC | Clinic/Center | 883 S Main St, Centerville, OH 45458-3440 | 2008-08-06 |
| 1396141784 | Matts Place | Clinic/Center | 190 South Main Street, Centerville, UT 84014-2814 | 2014-11-12 |
| 1396927596 | My Urban Clinic, Inc | Clinic/Center | 205 N Main St, Centerville, OH 45459-4617 | 2007-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689287997 | Asclepius Ai Inc | Clinic/Center | 800 Market St Ste 200, Chattanooga, TN 37402-2677 | 2020-08-26 |
| 1306459045 | Surgco, Plc | Clinic/Center | 107 Glen Oak Blvd Ste 201a, Hendersonville, TN 37075-3000 | 2020-08-24 |
| 1780207670 | Neelam Patel Md Inc | Clinic/Center | 276 Warfield Blvd, Clarksville, TN 37043-5952 | 2020-05-26 |
| 1306468152 | Advanced Spine and Wellness | Clinic/Center | 176 Thompson Ln Ste 102, Nashville, TN 37211-2468 | 2020-05-15 |
| 1821619560 | Takoma Regional Hospital, Inc. | Clinic/Center | 1021 Coolidge St Ste 5, Greeneville, TN 37743-4692 | 2020-05-05 |
| 1861013864 | Blue Ridge Medical Management C Orporation | Clinic/Center | 403 Princeton Rd Ste 10, Johnson City, TN 37601-2062 | 2020-04-30 |
| 1780205013 | Medworx | Clinic/Center | 4822 Old Hickory Blvd, Hermitage, TN 37076-2502 | 2020-04-28 |
| 1366078669 | Np Cares, LLC | Clinic/Center | 4515 Poplar Ave Ste 131, Memphis, TN 38117-7503 | 2020-03-18 |
| 1326670555 | East Memphis Urgent Medical Clinic PC | Clinic/Center | 6515 Poplar Ave Ste 106, Memphis, TN 38119-4878 | 2020-02-05 |
| 1225673395 | The Transformation Doctor, LLC Dba Wellnessmd | Clinic/Center | 3680 S Houston Levee Rd Ste 104, Collierville, TN 38017-9151 | 2019-11-13 |
| Find all providers with the same taxonomy | ||||
| City | CENTERVILLE |
| Zip Code | 37033 |
Please comment or provide details below to improve the information on ROBERT WILSON, DC, PLLC.
| 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.