Beverley Deloris Wilson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

16075 Issued in SC

Practice address

1 Harbison Way Ste 221
Columbia, SC 29212-3407

Phone

(803) 724-7560

Fax

(833) 320-1558

NPI assigned

Dec 15, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Beverley Deloris Stewart Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22257/brand/1/csg/1/fhir/r4

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1013079870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7756",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292027756",
            "telephone_number": "803-724-7560",
            "fax_number": "833-320-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HARBISON WAY STE 221",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292123407",
            "telephone_number": "803-724-7560",
            "fax_number": "833-320-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BEVERLEY",
        "middle_name": "DELORIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "16075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160756",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEVERLEY",
            "last_name": "STEWART",
            "middle_name": "DELORIS",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Marjorie Denise Wilson-Turner, LCPC
• A'Kaila Monae Wilson, M.A.,CCC-SLP
• Alex Mary Logan Wilson, DO
• Aliyah Inez Wilson
• Ayana Maia Wilson, MD
• Brenae Wilson, PHARMD
• Carol C Wilson, NP
• Cassandra Wilson, RT
• Catherine Marie Wilson
• Cynthia Ashleigh Wilson, RBT

• Pediatrics Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.