Robert Brent Wilder

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

35042804W Issued in OH

Practice address

18697 Bagley Rd
Middleburg Heights, OH 44130-3417

Phone

(440) 816-8000

NPI assigned

Jun 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rwilder@direct.swgeneral.com

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.

• Emergency Professional Services, Inc.

  dba Emergency Professional Services of Ohio, Inc.

  • Emergency Medicine Physician
  • Seaman, OH
  • NPI 1093762353
  Medicare reassignment NPD
• University Primary Care Practices Inc.

  • Durable Medical Equipment & Medical Supplies
  • Mentor, OH
  • NPI 1053405217
  NPD (past)
• Acute Care Specialists, Inc.

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1447294640
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1083654198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3881 E SMITH RD",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18697 BAGLEY RD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303417",
            "telephone_number": "440-816-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "ROBERT",
        "middle_name": "BRENT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35042804W",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0427710",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "942460636082",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR-GA",
            "identifier": "P00221626",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Todd Samuel Welsh, MD
• Westshore Primary Care Assoc., Inc.
• Westside Gastroenterologists, Inc.
• Tia Weybrecht
• Pavielle Chebenz White
• Shatesha Wilder
• John Wilhelm, MD
• Brian James Williams, M.D
• Keith Williams
• Stann Williams

• Emergency Medicine Physician in Middleburg Heights, OH
• Providers in Middleburg Heights, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.