DR. RICHARD C WILSON (NPI# 1972587350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972587350 |
| Entity Type | Individual |
| Full Name | DR. RICHARD C WILSON |
| Credential | DPM |
| Practice Address |
1515 Airport Blvd Melbourne FL 32901 |
| Mailing Address |
1515 Airport Blvd Melbourne FL 32901-2946 |
| Practice Telephone | 3217233500 |
| Practice Fax Number | 3217231945 |
| Mailing Telephone | 3217233500 |
| Mailing Fax Number | 3217231945 |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2019-10-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | 016003144 | IL | Podiatric Medicine & Surgery Service Providers |
| N | 213E00000X | Podiatrist | 421 | CO | Podiatric Medicine & Surgery Service Providers |
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
PO1322 | FL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 041009800 | 05 | |
| FL | BCBS | 87733 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 211 E New Haven Ave, Melbourne, FL 329014503 | 3217233500 | 3217231945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407158116 | Richard Chase Wilson | Internal Medicine | 1255 Clearview Circle, Allentown, PA 18103 | 2010-12-01 |
| 1902118409 | Richard Wilson | Counselor | 1421 Luisa St Ste C, Santa Fe, NM 87505-4073 | 2010-07-13 |
| 1316173768 | Richard Steven Wilson | Chiropractor | 2 Stony Hill Rd Ste 101, Bethel, CT 06801-1045 | 2009-05-29 |
| 1033358924 | Richard Robert Wilson | General Practice | 1276 Nursery Hill Ln, Arden Hills, MN 55112-5783 | 2009-02-17 |
| 1760633929 | Richard Allen Wilson | Dentist | 3828 W Davis St, Suite 310, Conroe, TX 77304-1815 | 2008-10-07 |
| 1649491937 | Richard S Wilson | Dentist | 6025 Harbour Park Dr, Midlothian, VA 23112-2160 | 2007-05-02 |
| 1104042761 | Richard Lyman Wilson | Dentist | 123 Weeminuche Ave, Ignacio, CO 81137 | 2007-04-18 |
| 1932228061 | Richard A Wilson | Dentist | 6007 Dempster St, Morton Grove, IL 60053-2943 | 2007-03-28 |
| 1568504447 | Richard Dale Wilson | Family Medicine | 306 Oakridge Rd, Cary, NC 27511-4542 | 2007-02-13 |
| 1225126691 | Richard Marsh Wilson | Psychologist | 554 Washington St, Suite 4, Wellesley, MA 02482-6408 | 2006-10-11 |
| Street Address |
1515 AIRPORT BLVD |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811992795 | Phillip W Devoe | Allergy & Immunology | 1515 Airport Blvd, Melbourne, FL 32901-2946 | 2005-06-16 |
| 1558701243 | Jessica Ann Ortega Wilson | Podiatrist | 1515 Airport Blvd, Melbourne, FL 32901 | 2013-06-27 |
| 1184064834 | Thomas Charles Wilson | Podiatrist | 1515 Airport Blvd, Melbourne, FL 32901 | 2013-06-26 |
| 1457589244 | Jared Briant Moyles | Podiatrist | 1515 Airport Blvd, Melbourne, FL 32901 | 2009-06-30 |
| 1003033465 | Phillip W Devoe Md Pa | Allergy & Immunology | 1515 Airport Blvd, Melbourne, FL 32901-2946 | 2007-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881057321 | Ryan Cantwell | Podiatrist | 2717 N Wickham Rd Ste 4, Melbourne, FL 32935-2200 | 2016-04-01 |
| 1639328396 | Robert Paul Dunne Dpm Pa | Podiatrist | 2717 N. Wickham Rd, Suite 4, Melbourne, FL 32935 | 2008-09-17 |
| 1275705899 | David A Weik Inc | Podiatrist | 1361 Bedford Dr, Suite 103, Melbourne, FL 32940-1984 | 2008-03-25 |
| 1831248699 | Sag Ventures, Inc | Podiatrist | 1051 Eber Blvd Ste 106, Melbourne, FL 32904-8768 | 2007-01-10 |
| 1518908672 | Robert Paul Dunne | Podiatrist | 2717 N Wickham Rd, Suite 4, Melbourne, FL 32935-2200 | 2006-06-09 |
| 1720698160 | Upperline Healthcare, PC | Podiatrist | 1601 S Apollo Blvd, Melbourne, FL 32901-4484 | 2020-07-31 |
| 1457883126 | Sara Elizabeth Lewis | Podiatrist | 205 E Nasa Blvd Fl 1, Melbourne, FL 32901-1950 | 2017-03-31 |
| 1629310099 | Fraaz M. Sayeed | Podiatrist | 1601 S Apollo Blvd, Melbourne, FL 32901 | 2013-03-22 |
| 1154565315 | Claudia R Mallette Dpm LLC | Podiatrist | 1555 W Nasa Blvd, Melbourne, FL 32901-2640 | 2009-04-30 |
| 1073755963 | Brian J Mallette Dpm LLC | Podiatrist | 200 S Harbor City Blvd, Suite302, Melbourne, FL 32901-1384 | 2009-03-24 |
| Find all providers in MELBOURNE | ||||
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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.