Individual provider Active NPI

Michael A. Wilson, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Mobile, AL
National Provider Identifier
1093790032
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
35775 Issued in AL
Practice address
5 Mobile Infirmary Cir
Mobile, AL 36607-3513
Phone
(251) 435-1200
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 18164 MS
Pulmonary Disease Physician 207RP1001X 10428 ND
Pulmonary Disease Physician 207RP1001X 7638A WY
Internal Medicine Physician 207R00000X 18164 MS
Pulmonary Disease Physician 207RP1001X 01065277A IN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 18164 MS
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 35775 AL Primary

Addresses

Primary practice location

5 Mobile Infirmary Cir
Mobile, AL 36607-3513

Mailing address

1700 Spring Hill Ave Ste 100
Mobile, AL 36604-1416
Phone (251) 435-1200

Other practice location 1

215 Marion Ave
McComb, MS 39648-2705
Phone (601) 249-5500

Other identifiers 2

IdentifierTypeStateIssuer
03857849MedicaidMS
273925900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, FL, LA, NC, AL5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20040511000337 MS Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Emergency Medicine 6103815501 Reassigns benefits to 4 organizations
I20051110000191 FL Practitioner - Critical Care (Intensivists) 6103815501 Reassigns benefits to 2 organizations
I20090527000202 LA Practitioner - Critical Care (Intensivists)Practitioner - Pulmonary Disease 6103815501 Reassigns benefits to 1 organization
I20090616000450 NC Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 6103815501
I20170705000687 AL Practitioner - Critical Care (Intensivists)Practitioner - Emergency Medicine 6103815501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
University of Florida College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imc-Diagnostic and Medical Clinic LLCGroup PAC ID 2860399623, 168 clinicians

Practice addresses (Care Compare)

1700 Springhill Ave
Suite 100
Mobile, AL 36604-1416
Phone (251) 435-1200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35775ALMDCritical Care Medicine (Internal Medicine) Physician
10428NDMDPulmonary Disease Physician
7638AWYMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Florida IV, LLC Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients
Keystone Medical Services of Ms, Inc CurrentSince Mar 1, 2016 Accepting new patients
Delta Medical Group CurrentSince Nov 20, 2016 Accepting new patients
Cogent Healthcare of Jacksonville, LLC Internal Medicine CurrentSince Jun 1, 2015 Accepting new patients
University Medical Center Management Corporation CurrentSince Oct 27, 2020 Accepting new patients
Sound Physicians of Florida IV, LLC Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients
Singing River Health System CurrentSince Jul 1, 2018 Accepting new patients
Imc-Diagnostic and Medical Clinic LLC CurrentSince Mar 1, 2021 Accepting new patients
Cogent Healthcare of Jacksonville, LLC Internal Medicine CurrentSince Jun 1, 2015 Accepting new patients
App of Mississippi Ed, LLC CurrentSince May 1, 2018 Accepting new patients
Imc-Diagnostic and Medical Clinic LLC Internal Medicine CurrentSince Mar 1, 2021 Accepting new patients
Mobile Emergency Physicians, LLC CurrentSince May 15, 2017 Accepting new patients
University Medical Center Management Corporation Internal Medicine CurrentSince Oct 27, 2020 Accepting new patients
WKB Family Medicine Associates Past Accepting new patients
Indira Sastry and Willis-Knighton Pulmonary Disease Past Accepting new patients
University Internal Medicine Assoc LLP Internal Medicine Past Accepting new patients
Wyoming Health Medical Group, LLC Internal Medicine Past Accepting new patients
Delta Physician Practices Past Accepting new patients
Mountain Falls Clinic, P.C. Critical Care Medicine Past Accepting new patients
WK Bossier Pulmonary & Critical Care Clinic Critical Care Medicine PastSince Jul 1, 2007 Accepting new patients
Sterling Critical Care Services of Colorado, LLC Critical Care Medicine Past Accepting new patients
Pensacola Lung Group, M.D.'S, P.a. Past Accepting new patients
Allendale County Hospital Board Past Accepting new patients

Locations

1700 Spring Hill Ave
Ste 100
Mobile, AL 36604

6801 Airport Blvd
Mobile, AL 36608
Phone (251) 266-3580

1725 Spring Hill Ave
Mobile, AL 36604
Phone (251) 435-1366

5 Mobile Infirmary Cir
Mobile, AL 36607
Phone (251) 432-4415

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

3100 E Fletcher Ave
#C
Tampa, FL 33613

2000 Canal St
New Orleans, LA 70112
Phone (504) 702-2287

150 Reynoir St
Biloxi, MS 39530
Phone (228) 432-7817

1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303

1693 Fairgrounds Rd
Greenville, MS 38703
Phone (662) 378-3783

15200 Community Rd
Gulfport, MS 39503
Phone (228) 575-7000

15190 Community Rd
Ste 250
Gulfport, MS 39503
Phone (228) 539-0489

5001 Hardy St
Hattiesburg, MS 39402
Phone (601) 268-8000

1850 Chadwick Dr
Jackson, MS 39204
Phone (601) 376-1000

100 Hospital Dr
Tylertown, MS 39667
Phone (601) 876-0455

2100 Highway 61 N
Vicksburg, MS 39183
Phone (601) 883-5001

5121 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 436-6556

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 23

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.

View all 23

Hospital & facility affiliations 3

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1093790032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SPRING HILL AVE STE 100",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041416",
            "telephone_number": "251-435-1200",
            "fax_number": "251-435-6357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MOBILE INFIRMARY CIR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366073513",
            "telephone_number": "251-435-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 Marion Ave",
            "address_purpose": "LOCATION",
            "city": "McComb",
            "state": "MS",
            "postal_code": "396482705",
            "country_code": "US",
            "telephone_number": "601-249-5500",
            "fax_number": "601-249-1173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHAEL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MS",
            "license": "18164",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "ND",
            "license": "10428",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WY",
            "license": "7638A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "18164",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01065277A",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MS",
            "license": "18164",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "AL",
            "license": "35775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03857849",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273925900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.