OrganizationActive
Nelson Wilson, IV
NPI 1912141516 · Prosthetic/Orthotic Supplier · Clinton, MS
Provider details
- NPI number
- 1912141516
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Nelson Wilson, Owner(601) 951-7012
- License
- C36423 (MS)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(85/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
801 E Northside Dr
Suite D
Clinton, MS 39056-3663
Phone: (601) 924-2888
Fax: (601) 924-2885
Street-level locationGet directions
Mailing address
801 E Northside Dr
Clinton, MS 39056-3663
Other names (DBA / former)
- Doing business as
- Extended Care Prosthetics of Mississippi
Registry dates
- Enumerated
- 2009-04-27
- Last updated
- 2009-05-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.