Individual provider Active NPI

Charles Ford Wilson II

  • Hearing Instrument Specialist
  • Staunton, VA
National Provider Identifier
1063179836
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
2101002596 Issued in VA
Practice address
1027 Richmond Ave Ste 107
Staunton, VA 24401-5087
Phone
(540) 886-4490
NPI assigned
Nov 29, 2021
Last updated
Nov 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 2101002596 VA Primary

Addresses

Primary practice location

1027 Richmond Ave Ste 107
Staunton, VA 24401-5087

Mailing address

64 Granary Rd
Verona, VA 24482-2534
Phone (540) 487-1911

Other practice location 1

338 Neff Ave
Harrisonburg, VA 22801-3429
Phone (540) 830-2042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2101002596VAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
South Atlantic Hearing LLC Hearing Instrument Specialist PastSince Dec 5, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1063179836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 GRANARY RD",
            "city": "VERONA",
            "state": "VA",
            "postal_code": "244822534",
            "telephone_number": "540-487-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 RICHMOND AVE STE 107",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244015087",
            "telephone_number": "540-886-4490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "338 Neff Ave",
            "address_purpose": "LOCATION",
            "city": "Harrisonburg",
            "state": "VA",
            "postal_code": "228013429",
            "country_code": "US",
            "telephone_number": "540-830-2042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHARLES",
        "middle_name": "FORD",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-29",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "VA",
            "license": "2101002596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staunton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.