DR. IAN JERMAINE WILSON (NPI# 1871793570) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871793570 |
Entity Type | Individual |
Full Name | DR. IAN JERMAINE WILSON |
Credential | M.D. |
Practice Address |
1892 Winton Rd S Ste 190 Rochester NY 14618-3996 |
Practice Telephone | 5859020444 |
Practice Fax Number | 5854175513 |
Mailing Telephone | 5859020444 |
Mailing Fax Number | 5854175513 |
Enumeration Date | 2007-07-20 |
Last Update Date | 2018-03-17 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
244637 | NY | Allopathic & Osteopathic Physicians |
N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
244637 | NY | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | 02933948 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
1892 Winton Rd S Ste 190, Rochester, NY 146183996 | 5859020444 | 5854175513 |
601 Elmwood Ave, Rochester, NY 146420001 | 5852751381 | 5852731003 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750729216 | Ian William Wilson | Licensed Practical Nurse | 2141 Crotona Ave, Apt. 2b, Bronx, NY 10457-2705 | 2013-06-06 |
1730484858 | Ian Thomas Wilson | Counselor | 1600 E Olive St, Sound Mental Health, Seattle, WA 98122-2735 | 2011-01-20 |
1568781615 | Ian Glen Wilson | Behavioral Analyst | 6400 Tupelo Dr, Citrus Heights, CA 95621-1741 | 2010-05-27 |
1023238243 | Ian Fitzsimmons Wilson | Surgery | 10000 Bay Pines Blvd, Baypines, FL 33744 | 2007-04-27 |
1760598239 | Ian J Wilson | Internal Medicine | 625 Africa Rd Ste 200, Westerville, OH 43082 | 2006-08-21 |
Street Address |
1892 WINTON RD S STE 190 |
City | ROCHESTER |
State | NY |
Zip Code | 14618-3996 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962056499 | Zahavi Dental of Rochester | Dentist | 1815 S. Clinton Ave, 510, Rocheter, NY 14618 | 2019-08-01 |
1760047278 | Inner Power Physical Therapy Pllc | Clinic/Center | 2561 Lac Deville Boulevard, Suite 100, Rochester, NY 14618 | 2019-05-09 |
1659859858 | Steven Sanfilippo | Counselor | 2000 S. Winton Rd., Building 4, Suite 303, Rochester, NY 14618 | 2018-07-31 |
1578064853 | Feet First Inc | Durable Medical Equipment & Medical Supplies | 1900 Clinton Ave S Ste 5, Rochester, NY 14618 | 2018-02-22 |
1558805374 | Jennifer Virella | Social Worker | 2000 South Winton Road, Bldg 2, Rochester, NY 14618 | 2016-12-13 |
1235589300 | Andrew Cyrus Marcy | Nurse Practitioner | 95 Allens Creek Road Bld 1 Ste 306, Rochester, NY 14618 | 2016-06-20 |
1932561073 | Legacy Pediatrics | Pediatrics | 1815 South Clinton Avenue Ste 360, Rochester, NY 14618 | 2016-03-28 |
1790143105 | Marie Lynn Bieber | Dietitian, Registered | 919 Winton Rd S Ste 220, Rochester, NY 14618 | 2016-02-01 |
1720443096 | Brittany Rose Masetta | Marriage & Family Therapist | 2000 S Winton Rd, Bldg 4, Suite #200, Rochester, NY 14618 | 2015-12-30 |
1437543097 | Kathleen Skye Kemp | Internal Medicine | 2400 S Clinton Ave Ste G2, Rochester, NY 14618 | 2015-03-22 |
Find all providers in zip 14618 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306333109 | John Warren Kirby | Radiology | 200 1st St Sw # 507284, Rochester, MN 55905 | 2018-04-17 |
1235687088 | Jeffery E. Illman | Radiology | 1082 Southern Ridge Dr Sw, Rochester, MN 55902-1854 | 2016-09-21 |
1518209675 | Peter Alan Dvorak | Radiology | 36 Edgemont Rd, Rochester, NY 14620-4520 | 2013-03-26 |
1144519992 | Daniel C Oppenheimer | Radiology | 601 Elmwood Ave Box 648, Rochester, NY 14642-1016 | 2011-04-01 |
1992094072 | Joel P Thompson | Radiology | 995 Senator Keating Blvd Ste 100, Rochester, NY 14618-2777 | 2011-03-29 |
1487860482 | Nadia Fatima Yusaf | Radiology | 2623 South Clinton Ave, Rochester, NY 14618-2623 | 2007-05-15 |
1356413470 | Man-mei Nadine Su | Radiology | 1776 11th Ave Ne, Rochester, MN 55906-4215 | 2006-11-14 |
1639184377 | Arun Basu | Radiology | 601 Elmwood Ave # 648, Rochester, NY 14642-0001 | 2006-07-30 |
1811901135 | Devang Butani | Radiology | 601 Elmwood Ave / Univ. of Roch. Med Ctr, Imaging Sciences, Box 648, Rochester, NY 14642-1698 | 2006-07-29 |
1801822853 | Michael Joseph Johnston | Radiology | 102 Elton Hills Dr Nw, Rochester, MN 55901-3562 | 2006-06-23 |
Find all providers in ROCHESTER |
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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.