NPIMap

Individual provider Active NPI

Robert B Wilson, M.D.

  • Diagnostic Radiology Physician
  • Jacksonville, FL
National Provider Identifier
1083909246
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2017-02394 Issued in NC
Practice address
2005 Knight Lane BLDG H
Navy Medicine Support Command Attn: Medical Staff Servs
Jacksonville, FL 32212-0140
Phone
(619) 532-5998
NPI assigned
Jun 16, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X 2017-02394 NC Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2005 Knight Lane BLDG H
Navy Medicine Support Command Attn: Medical Staff Servs
Jacksonville, FL 32212-0140

Mailing address

1025 Medical Center Dr
Wilmington, NC 28401-7354
Phone (843) 822-5470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20210527000739 NC Practitioner - Diagnostic Radiology 2860782810 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical University of South Carolina College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delaney Radiologists Group PLLCGroup PAC ID 4981684875, 55 clinicians
Delaney Radiologists PAGroup PAC ID 6305813684, 55 clinicians

Practice addresses (Care Compare)

1025 Medical Ctr Dr
Wilmington, NC 28401-7354
Phone (910) 762-3882

Hospital & facility affiliations

  • Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141
  • Novant Health Brunswick Medical Center Hospital, Supply, NC, CCN 340158
  • J Arthur Dosher Memorial Hospital Hospital, Southport, NC, CCN 341327
  • Onslow Memorial Hospital Hospital, Jacksonville, NC, CCN 340042
  • Pender Memorial Hospital Hospital, Burgaw, NC, CCN 341307

Merit-based Incentive Payment System (MIPS)

Final score
83.57 of 100Reported as group
Quality
80.67
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
81.72 of 100Reported as group
Quality
88.57
Improvement activities
40
Cost
60.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N/ANCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Delaney Radiologists Group PLLC Multi-Specialty CurrentSince Jul 19, 2021 Accepting new patients
Delaney Radiologists PA Multi-Specialty CurrentSince Jul 19, 2021 Accepting new patients
Wilmington ASC LLC CurrentSince Jul 19, 2021 Accepting new patients
Wilmington Health PLLC Multi-Specialty CurrentSince Jul 19, 2021 Accepting new patients

Locations

2000 Brabham Ave
Ste 110
Jacksonville, NC 28546
Phone (910) 939-3110

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

1025 Medical Center Dr
Wilmington, NC 28401
Phone (910) 762-3882

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

Interoperability endpoints

  • Direct secure messaging: rwilson883613@direct.novanthealth.org

Organizations & group practices 4

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 10

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": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1083909246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017354",
            "telephone_number": "843-822-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 KNIGHT LANE BLDG H",
            "address_2": "NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAFF SERVS",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322120140",
            "telephone_number": "619-532-5998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ROBERT",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-16",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2017-02394",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.