NPIMap

Individual provider Active NPI

Charles Henry Wilson IV, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Mobile, AL
National Provider Identifier
1053472712
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
28933 Issued in AL
Practice address
6144 Airport Blvd
Mobile, AL 36608
Phone
(251) 476-5050
Fax
(251) 450-2770
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X ME84712 FL
Orthopaedic Surgery Physician 207X00000X 28933 AL
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 28933 AL
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 28933 AL Primary

Addresses

Primary practice location

6144 Airport Blvd
Mobile, AL 36608

Mailing address

PO Box 86144
Mobile, AL 36689-6144
Phone (251) 476-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20081028000667 AL Practitioner - Orthopedic Surgery 5698833093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Alabama School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Orthopaedic Group PCGroup PAC ID 2264331826, 67 clinicians

Practice addresses (Care Compare)

106 Saraland Loop
Suite 106 1
Saraland, AL 36571-2419
Phone (251) 476-5050

2016 S Alabama Ave
Monroeville, AL 36460-3044
Phone (251) 476-5050

3610 Springhill Memorial Dr N
Mobile, AL 36608-1162
Phone (251) 476-5050

6144 Airport Blvd
Mobile, AL 36608-3143
Phone (251) 476-5050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
86.51
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement86
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME84712FLMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Orthopaedic Group, PC Orthopaedic Surgery CurrentSince Aug 1, 2008 Accepting new patients
The Orthopaedic Group, P.C. Orthopaedic Surgery CurrentSince Aug 1, 2008 Accepting new patients

Locations

3610 Springhill Memorial Dr N
Mobile, AL 36608
Phone (251) 344-9630

6144 Airport Blvd
Mobile, AL 36608
Phone (251) 342-0004

6144 Airport Blvd
#A
Mobile, AL 36608
Phone (251) 438-3614

2016 S Alabama Ave
Monroeville, AL 36460
Phone (251) 575-3111

106 Saraland Loop
Ste 1061
Saraland, AL 36571

880 Industrial Pkwy
Ste Hi
Saraland, AL 36571

Interoperability endpoints

  • Direct secure messaging: cwilson@tog1813.srs-direct.com

Organizations & group practices 2

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 8

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

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1053472712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86144",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366896144",
            "telephone_number": "251-476-5050",
            "fax_number": "251-450-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6144 AIRPORT BLVD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36608",
            "telephone_number": "251-476-5050",
            "fax_number": "251-450-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHARLES",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME84712",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AL",
            "license": "28933",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "AL",
            "license": "28933",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AL",
            "license": "28933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.