JASON EDWARD WILDER (NPI# 1922019355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922019355 |
| Entity Type | Individual |
| Full Name | JASON EDWARD WILDER |
| Credential | R, MR |
| Practice Address |
1504 Hardeman Ave Suite B Macon GA 31201-1416 |
| Mailing Address |
4921 Wesleyan Cir Macon GA 31210-2222 |
| Practice Telephone | 4787453135 |
| Practice Fax Number | 4787453136 |
| Mailing Telephone | 4784778969 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 247100000X | Radiologic Technologist | 330869 | Technologists, Technicians & Other Technical Service Providers | |
| X | 2471C3402X |
Radiologic Technologist Specialization: Radiography |
330869 | Technologists, Technicians & Other Technical Service Providers | |
| X | 2471M1202X |
Radiologic Technologist Specialization: Magnetic Resonance Imaging |
330869 | Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679539670 | Jason A Wilder | Physical Therapist | 210 S Cumberland St, Morristown, TN 37813-2301 | 2006-04-26 |
| 1952327629 | Jason Matthew Wilder | Dermatology | 160 Hawley Ln, Suite 104, Trumbull, CT 06611-5300 | 2006-07-14 |
| Street Address |
1504 HARDEMAN AVE SUITE B |
| City | MACON |
| State | GA |
| Zip Code | 31201-1416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730158601 | Physicians Mri Inc | Clinic/Center | 1504 Hardeman Ave, Suite B, Macon, GA 31201 | 2006-03-14 |
| 1679812432 | Ashley Danielle Radford | Radiologic Technologist | 1504 Hardeman Ave, Ste B, Macon, GA 31201-1441 | 2013-02-13 |
| 1083951867 | Tricia Marie Mizell | Radiologic Technologist | 1504 Hardeman Ave, Suite B, Macon, GA 31201-1441 | 2013-01-14 |
| 1538479043 | Russell Scott Gibson | Radiologic Technologist | 1504 Hardeman Ave, Suite B, Macon, GA 31201-1441 | 2010-10-18 |
| 1114077401 | Casey Lee Fordham | Radiologic Technologist | 1504 Hardeman Ave, Macon, GA 31201-1416 | 2007-01-11 |
| 1821101783 | David L Burdett | Radiologic Technologist | 1504 Hardeman Ave, Ste B, Macon, GA 31201-1416 | 2006-08-16 |
| 1275544652 | Judy Lynn Cooper | Radiologic Technologist | 1504 Hardeman Ave, Suite B, Macon, GA 31201-1416 | 2006-08-10 |
| 1568473957 | Christopher Shannon Harris | Radiologic Technologist | 1504 Hardeman Ave, Suite B, Macon, GA 31201-1416 | 2006-08-10 |
| 1801807201 | Deborah Ann Kovalick-leggett | Radiologic Technologist | 1504 Hardeman Ave, Suite B, Macon, GA 31201-1416 | 2006-08-10 |
| 1891706214 | Duane Ennis | Radiologic Technologist | 1504 Hardeman Ave, Suite B, Macon, GA 31201-1416 | 2006-08-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639666340 | Yasameen Emad Muzahim | Internal Medicine | 777 Hemlock Street, Msc 165, Macon, GA 31201 | 2018-04-18 |
| 1952819419 | Putnam Dialysis LLC | Clinic/Center | 657 Hemlock Street, Suite 200, Macon, GA 31201 | 2018-01-18 |
| 1730604331 | Graham Arthur Mercier | Surgery | 169 Ashley Ave., Room 202 Main Hospital Msc 333, Charleston, SC 31201 | 2017-08-04 |
| 1376075705 | Diamond Jude | Internal Medicine | 777 Hemlock Street Msc #104, Macon, GA 31201 | 2017-04-03 |
| 1174055263 | Carol Roobin Bashuk | Hearing Instrument Specialist | 634 First Street, Macon, GA 31201 | 2017-03-29 |
| 1144752411 | Hubert Pare | Student in an Organized Health Care Education/Training Program | 777 Hemlock Street, Msc# 165, Macon, GA 31201 | 2017-03-28 |
| 1548613789 | Michael Daugherty | Counselor | 1873 Hardeman Ave, Suite 1, Macon, GA 31201 | 2016-07-22 |
| 1316317993 | 4front Healthcare of Middle Georgia, LLC | Hospice Care, Community Based | 682 1st St, Macon, GA 31201 | 2015-09-25 |
| 1881073054 | Andrew Lee Drahos | Surgery | 777 Hemlock St # 140, Macon, GA 31201 | 2015-05-21 |
| 1720474158 | April Nicole Colley | Nurse Practitioner | 1014 Forsyth Street, Macon, GA 31201 | 2015-04-13 |
| Find all providers in zip 31201 | ||||
| Taxonomy Code | 247100000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083951867 | Tricia Marie Mizell | Radiologic Technologist | 1504 Hardeman Ave, Suite B, Macon, GA 31201-1441 | 2013-01-14 |
| 1114077401 | Casey Lee Fordham | Radiologic Technologist | 1504 Hardeman Ave, Macon, GA 31201-1416 | 2007-01-11 |
| 1821101783 | David L Burdett | Radiologic Technologist | 1504 Hardeman Ave, Ste B, Macon, GA 31201-1416 | 2006-08-16 |
| 1275544652 | Judy Lynn Cooper | Radiologic Technologist | 1504 Hardeman Ave, Suite B, Macon, GA 31201-1416 | 2006-08-10 |
| 1568473957 | Christopher Shannon Harris | Radiologic Technologist | 1504 Hardeman Ave, Suite B, Macon, GA 31201-1416 | 2006-08-10 |
| 1801807201 | Deborah Ann Kovalick-leggett | Radiologic Technologist | 1504 Hardeman Ave, Suite B, Macon, GA 31201-1416 | 2006-08-10 |
| 1891706214 | Duane Ennis | Radiologic Technologist | 1504 Hardeman Ave, Suite B, Macon, GA 31201-1416 | 2006-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801281100 | On-site Imaging Solutions LLC | Radiologic Technologist | 10755 Brunson Dr, Johns Creek, GA 30097-8465 | 2015-04-02 |
| 1013318948 | Patti Catlett | Radiologic Technologist | 3060 Cypress Cv, Ball Ground, GA 30107-2675 | 2014-09-10 |
| 1033471669 | Vincent Paul Jackson | Radiologic Technologist | 4950 Glaze Dr, Atlanta, GA 30360-1702 | 2012-06-11 |
| 1184870115 | David Anthony Hardwick | Radiologic Technologist | 3198 Trinity Mill Cir, Dacula, GA 30019-1036 | 2008-08-11 |
| 1154584555 | Kathy C Isley | Radiologic Technologist | Lockheed Martin Aeronautics Co, 86 South Cobb Drive, Dept Re2m, Zone 0454, Marietta, GA 30063-0001 | 2008-07-07 |
| 1639298276 | Brian L Jones | Radiologic Technologist | 203 Pineywood Rd, Griffin, GA 30224-4964 | 2007-03-28 |
| 1346255080 | Open Mri of Milledgeville LLC | Radiologic Technologist | 1850 North Columbia Street, Suite 3, Milledgeville, GA 31061-7113 | 2006-07-30 |
| 1134151079 | Tina Marie Sapp | Radiologic Technologist | 1401 Tift Ave N, Tifton, GA 31794-3585 | 2006-07-07 |
| 1265421614 | Greene David Mock | Radiologic Technologist | 34 Diana Dr, Savannah, GA 31406-7510 | 2005-10-18 |
| 1750908927 | Cassidy Davis | Radiologic Technologist | 501 Redmond Rd Nw, Rome, GA 30165-1415 | 2020-07-02 |
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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.