Individual provider Active NPI

Victoria V Wilson, MD

  • Family Medicine Physician
  • Eldersburg, MD
National Provider Identifier
1063699569
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0067957 Issued in MD
Practice address
1380 Progress Way Ste 102
Eldersburg, MD 21784-6498
Phone
(443) 289-3400
Fax
(443) 289-3480
NPI assigned
Jan 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0067957 MD Primary

Addresses

Primary practice location

1380 Progress Way Ste 102
Eldersburg, MD 21784-6498

Mailing address

1380 Progress Way Ste 102
Eldersburg, MD 21784-6498
Phone (443) 289-3400

Other identifiers 1

IdentifierTypeStateIssuer
420227900MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101217000639 MD Practitioner - Family Practice 8022178599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carroll Health Group LLCGroup PAC ID 3870627029, 68 clinicians

Practice addresses (Care Compare)

1380 Progress Way
Suite 102
Eldersburg, MD 21784-6498
Phone (410) 795-0257

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0067957MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carroll Health Group, LLC Family Medicine CurrentSince Jan 1, 2012 Accepting new patients
Carroll Health Group, LLC Family Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Carroll Health Group, LLC PastSince Apr 27, 2025 Accepting new patients
Associates in Family Practice PA Family Medicine PastSince Dec 21, 2025 Accepting new patients
Family Medical Associates,LLC Family Medicine Past Accepting new patients

Locations

1380 Progress Way
Ste 102
Eldersburg, MD 21784
Phone (410) 795-0257

113 Westminster Pike
Ste 101
Reisterstown, MD 21136
Phone (410) 517-2840

193 Stoner Ave
Ste 220
Westminster, MD 21157
Phone (410) 871-2204

295 Stoner Ave
#S301
Westminster, MD 21157
Phone (410) 876-1614

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1063699569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 PROGRESS WAY STE 102",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846498",
            "telephone_number": "443-289-3400",
            "fax_number": "443-289-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 PROGRESS WAY STE 102",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846498",
            "telephone_number": "443-289-3400",
            "fax_number": "443-289-3480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "VICTORIA",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-28",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0067957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420227900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldersburg, MD

Sources for this page

Verify at the official NPI Registry.