NPIMap

Individual provider Active NPI

Brian Sean Wilson, DC

  • Chiropractor
  • Wintersville, OH
National Provider Identifier
1063414720
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2674 Issued in OH
Practice address
1562 Cadiz Rd
Wintersville, OH 43953-7630
Phone
(740) 264-6235
Fax
(740) 264-9395
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2674 OH Primary

Addresses

Primary practice location

1562 Cadiz Rd
Wintersville, OH 43953-7630

Mailing address

1562 Cadiz Rd
Wintersville, OH 43953-7630
Phone (740) 264-6235

Other identifiers 1

IdentifierTypeStateIssuer
2057983MedicaidOH

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Schrickel Chiropractic, Inc Chiropractor Past Accepting new patients
Heights Chiropractic Physicians, LLC Chiropractor Past Accepting new patients
Wintersville Medical Group LLC PastSince May 4, 2010 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1063414720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1562 CADIZ RD",
            "city": "WINTERSVILLE",
            "state": "OH",
            "postal_code": "439537630",
            "telephone_number": "740-264-6235",
            "fax_number": "740-264-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1562 CADIZ RD",
            "city": "WINTERSVILLE",
            "state": "OH",
            "postal_code": "439537630",
            "telephone_number": "740-264-6235",
            "fax_number": "740-264-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRIAN",
        "middle_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2057983",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wintersville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; 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.