Dennis Wayne Wilson, PHD is a medicare enrolled "Psychologist - Clinical" provider in Milan, Tennessee. His current practice location is
1020 Ellington Dr, Milan, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(731) 431-0609.
Dennis Wayne Wilson is licensed to practice in Tennessee (license number P0000001010) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1780625202.
Healthcare Provider's Profile
| Full Name | Dennis Wayne Wilson |
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| Gender | Male |
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| Speciality | Psychologist - Clinical |
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| Location | 1020 Ellington Dr, Milan, Tennessee |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1780625202
- Provider Enumeration Date: 06/08/2006
- Last Update Date: 06/08/2011
Medicare PECOS Information:
- PECOS PAC ID: 0143232587
- Enrollment ID: I20060718000304
Medical Identifiers
Medical identifiers for Dennis Wayne Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780625202 | NPI | - | NPPES |
| 36815541 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TC0700X | Psychologist - Clinical | P0000001010 (Tennessee) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dennis Wayne Wilson allows following entities to bill medicare on his behalf.
| Entity Name | Dennis W Wilson Phd Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1356533137
PECOS PAC ID: 0840389417
Enrollment ID: O20071204000788 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dennis Wayne Wilson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dennis Wayne Wilson, PHD
728 Blackmon Street,
Medina, TN 38355-6829
Ph: (731) 431-0609 | Dennis Wayne Wilson, PHD
1020 Ellington Dr,
Milan, TN 38358-3150
Ph: (731) 431-0609 |
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