Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1649458662 Individual Practitioner Female Practitioner

Bernice Wilson

Specialist • Fort Wayne, IN

Professional Overview & Biography Verified Profile Summary

Bernice Wilson is a registered healthcare professional specializing in Specialist in Fort Wayne, IN. Practice services are available at 4202 BUELL DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4202 Buell Dr

Fort Wayne, IN 468072743

Telephone 2603414756

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Fort Wayne, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 38.5 Yrs
State Avg: 34.9 Yrs
Regional Practice Density
30 Specialists

Practicing in Fort Wayne, IN (456 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License IN 32001561A

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Cota
32001561A (IN)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active January 31, 2008

NPI status registered as active in NPPES database

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Updated Practice Location January 31, 2008

Registered at 4202 BUELL DR, FORT WAYNE, IN 468072743 (Tel: 2603414756)

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Updated Business Mailing Address January 31, 2008

Registered at 4202 BUELL DR, FORT WAYNE, IN 468072743 (Tel: 2603414756)

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Provider Name / Credentials Updated January 31, 2008

Recorded as BERNICE WILSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 31, 2008

Specialist (License #32001561A in IN)

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Initial NPI Registration & Enumeration January 31, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1649458662
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 31, 2008
Last Update: January 31, 2008
Sole Proprietor: Yes

Mailing Address

4202 Buell Dr

Fort Wayne, IN 468072743

Phone: 2603414756

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.