Jeffrey Wilson, MD
Jeffrey Wilson, MD is an Interventional Cardiology Physician in Fenton, MO, registered under NPI 1003287079. This provider registers 3 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
Here is what surrounds this office in Fenton, based on OpenStreetMap data collected Sep 16, 2026. Parking is available about 328 ft away at Lot F. A pharmacy sits 0.26 mi from the entrance (Walgreens), which helps if you leave with a prescription.
Getting here and what is nearby
Parking Lot E 288 ft ~2 min
Parking Lot G 307 ft ~2 min
Parking Lot F 328 ft ~2 min
Pharmacy Walgreens 0.26 mi ~6 min
Restaurant Burger King 0.27 mi ~6 min
Restaurant Culver's 0.30 mi ~6 min
1024 Bowles Avenue, Fenton 63026
Mo-Su 10:00-22:00
Convenience On the Run 0.32 mi ~7 min
1000 Bowles Avenue, Fenton 63026
Gas station Mobil 0.32 mi ~7 min
Convenience Circle K 0.36 mi ~8 min
900 Brookwood Center, Fenton 63026
Gas station Shell 0.36 mi ~8 min
900 Brookwood Center, Fenton 63026
Distances are straight‑line estimates — walking routes may be longer. Hours and phone numbers can change; call ahead to confirm.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 147427 | MT | Interventional Cardiology Physician |
| 036165783 | IL | Cardiovascular Disease Physician |
| 036165783 | IL | Interventional Cardiology Physician |
| 2025010674 | MO | Interventional Cardiology Physician primary |
| 036165783 | IL | Internal Medicine Physician |
| 10415 | SD | Interventional Cardiology Physician |
Licences are recorded in 4 states: MT, IL, MO, SD. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Interventional Cardiology
- PAC ID
- 4981999893
Enrolled in Medicare 5 times, across 5 states:
| State | Enrollment ID | Provider type |
|---|---|---|
| South Dakota | I20210505002990 | Practitioner - Interventional Cardiology |
| Illinois | I20231018000565 | Practitioner - Interventional Cardiology |
| Missouri | I20250505000472 | Practitioner - Cardiovascular Disease (cardiology) |
| Wyoming | I20251002002658 | Practitioner - Interventional Cardiology |
| Montana | I20260505000189 | Practitioner - Cardiovascular Disease (cardiology) |
Medicare enrolment is recorded as approved under the provider type Practitioner - Interventional Cardiology. There are 5 separate enrolment records across 5 states (SD, IL, MO, WY, MT). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 4 states
This provider holds licences in 4 states: Illinois, Missouri, Montana and South Dakota. The practice address on file is in Fenton, MO, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- 2025010674
- Specialty
- Interventional Cardiology Physician
- Licence
- 10415
- Specialty
- Interventional Cardiology Physician
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Interventional Cardiology covers
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. NUCC Health Care Provider Taxonomy, code 207RI0011X
All registered taxonomy codes
This provider registers 6 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207RI0011X | Interventional Cardiology Physician Interventional Cardiology | 147427 | MT | |
| 207RC0000X | Cardiovascular Disease Physician Cardiovascular Disease | 036165783 | IL | |
| 207RI0011X | Interventional Cardiology Physician Interventional Cardiology | 036165783 | IL | |
| 207RI0011X | Interventional Cardiology Physician Interventional Cardiology | 2025010674 | MO | primary |
| 207R00000X | Internal Medicine Physician | 036165783 | IL | |
| 207RI0011X | Interventional Cardiology Physician Interventional Cardiology | 10415 | SD |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1003287079 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Oct 15, 2015 |
| Last updated | Jul 16, 2026 |
| Status | Active |
| Sole proprietor | No |
| Gender | Male |
| Credential | MD |
| Practice address |
1011 BOWLES AVE STE 300 Fenton, MO 63026 (636) 496-5065 |
| Mailing address |
345 W STEAMBOAT DR STE 601 North Sioux City, SD 57049 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 0 | 3 | 2 | 8 | 7 | 0 | 7 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 0 | 3 | 4 | 8 | 5 | 0 | 5 |
Sum = 51 · next multiple of 10 = 60 · check digit = 9 · actual last digit = 9
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.