NPIMap

Individual provider Active NPI

Patrick Aloysius Wilson, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Charlotte, NC
National Provider Identifier
1013913128
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
9500774 Issued in NC
Practice address
200 Hawthorne LN
Presbyterian Hospital Department of Pathology
Charlotte, NC 28204-2515
Phone
(704) 384-4814
Fax
(704) 384-5770
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 9500774 NC Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X C10004857 DE

Addresses

Primary practice location

200 Hawthorne LN
Presbyterian Hospital Department of Pathology
Charlotte, NC 28204-2515

Mailing address

200 Hawthorne LN
Presbyterian Hospital Department of Pathology
Charlotte, NC 28204-2515
Phone (704) 384-4814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070702000362 NC Practitioner - Pathology 5799885885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of North Carolina at Chapel Hill School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Pathology Group PLLCGroup PAC ID 7810955168, 23 clinicians

Practice addresses (Care Compare)

10030 Gilead Rd
Huntersville, NC 28078-7545
Phone (704) 316-4000

10905 Providence Rd W
Charlotte, NC 28277-1538
Phone (704) 384-4814

1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-6500

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-4815

8201 Health Loop
Charlotte, NC 28215-7072
Phone (980) 302-1410

Hospital & facility affiliations

  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
  • Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183
  • Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
  • Novant Health Rowan Medical Center Hospital, Salisbury, NC, CCN 340015
  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C10004857DEMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Pathology Group PLLC Anatomic Pathology & Clinical Pathology CurrentSince Jul 16, 2007 Accepting new patients

Locations

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

5700 Southwyck Blvd
Toledo, OH 43614

Ownership & related parties

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Presbyterian Hospital HuntersvilleHuntersville, NC, CCN 340183 Hospital Corporate Officer May 1, 2023
Novant Health Matthews Medical CenterMatthews, NC, CCN 340171 Hospital Corporate Officer May 1, 2023
Novant Health Presbyterian Medical CenterCharlotte, NC, CCN 340053 Hospital Corporate Director May 1, 2023
Presbyterian Behavioral Health UnitCharlotte, NC, CCN 34S053 Hospital Corporate Director May 1, 2023
Novant Health Mint Hill Medical CenterCharlotte, NC, CCN 340190 Hospital Corporate Director May 1, 2023
Novant Health Ballantyne Medical CenterCharlotte, NC, CCN 340195 Hospital Corporate Director May 1, 2023
Novant Health Presbyterian Medical CenterCharlotte, NC, CCN 345467 Skilled nursing facility Corporate Director May 1, 2023

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1013913128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE LN",
            "address_2": "PRESBYTERIAN HOSPITAL DEPARTMENT OF PATHOLOGY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042515",
            "telephone_number": "704-384-4814",
            "fax_number": "704-384-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE LN",
            "address_2": "PRESBYTERIAN HOSPITAL DEPARTMENT OF PATHOLOGY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042515",
            "telephone_number": "704-384-4814",
            "fax_number": "704-384-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "PATRICK",
        "middle_name": "ALOYSIUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "9500774",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "DE",
            "license": "C10004857",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.