Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jeffrey P Wilson, MD

Individual provider Interventional Cardiology Physician · NPI 1003287079

Dr. Jeffrey P Wilson, MD is an Interventional Cardiology in Fenton, Missouri. Qualified in 2013, 13 years ago. Practices with Sage Medical Prof LLC, a 15-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Illinois, Missouri, Montana and South Dakota.

Years since qualifying
13
Licensed in
IL, MO, MT, SD
In the registry since
2015
Specialties on file
6
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1011 Bowles Ave Ste 300
Fenton, MO 63026-2387
Phone: (636) 496-5065
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 2300 N Edward St, Decatur, IL 62526-4192 — (217) 876-8121
  • 619 E Mason St, Springfield, IL 62701-1034 — (217) 788-0706
  • 1300 28th St S Fl 2, Great Falls, MT 59405-5296 — (406) 455-4230
  • 201 Anamaria Dr, Rapid City, SD 57701-7305 — (605) 503-8192

Specialties & licences

Interventional Cardiology Physician (primary) Taxonomy 207RI0011X · Licence 2025010674 (MO)
Interventional Cardiology Physician Taxonomy 207RI0011X · Licence 147427 (MT)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence 036165783 (IL)
Interventional Cardiology Physician Taxonomy 207RI0011X · Licence 036165783 (IL)
Internal Medicine Physician Taxonomy 207R00000X · Licence 036165783 (IL)
Interventional Cardiology Physician Taxonomy 207RI0011X · Licence 10415 (SD)

Record details

NPI number1003287079
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 15, 2015
Last updated in NPPESJuly 16, 2026
Certification dateJuly 16, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERVENTIONAL CARDIOLOGY
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Sage Medical Prof Llc — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Fenton