Individual provider Active NPI

Brian Alan Wilson, DO

  • Psychiatry Physician
  • Hot Springs, SD
National Provider Identifier
1093909293
Registry record updated Dec 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
8489 Issued in SD
Practice address
1201 Hwy 71 S.
Hot Springs, SD 57747-8800
Phone
(605) 745-8910
Fax
(605) 745-3957
NPI assigned
Aug 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 8489 SD Primary
Psychiatry Physician 2084P0800X 8589 SD

Addresses

Primary practice location

1201 Hwy 71 S.
Hot Springs, SD 57747-8800

Mailing address

1201 Hwy 71 S.
Hot Springs, SD 57747-8800
Phone (605) 745-8910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20130925000317 SD Practitioner - Psychiatry 5890939250 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5301 US-16
Rapid City, SD 57701-8700
Phone (605) 393-4278

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8489SDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Home Society of South Dakota Psychiatry CurrentSince May 20, 2024 Accepting new patients
Childrens Home Society of South Dakota Psychiatry CurrentSince May 20, 2024 Accepting new patients
State of South Dakota Past Accepting new patients
State of South Dakota Past Accepting new patients

Organizations & group practices 5

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": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451260800000",
    "number": "1093909293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 HWY 71 S.",
            "city": "HOT SPRINGS",
            "state": "SD",
            "postal_code": "577478800",
            "telephone_number": "605-745-8910",
            "fax_number": "605-745-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 HWY 71 S.",
            "city": "HOT SPRINGS",
            "state": "SD",
            "postal_code": "577478800",
            "telephone_number": "605-745-8910",
            "fax_number": "605-745-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRIAN",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-30",
        "last_updated": "2015-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SD",
            "license": "8489",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SD",
            "license": "8589",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs, SD

Sources for this page

Verify at the official NPI Registry.