Individual provider Active NPI

Russell Chapman Wilson, M.D.

  • Diagnostic Radiology Physician
  • Raleigh, NC
National Provider Identifier
1124068432
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Practice address
3949 Browning PL
Raleigh, NC 27609-6504
Phone
(919) 787-8221
Fax
(919) 789-4461
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NC Primary

Addresses

Primary practice location

3949 Browning PL
Raleigh, NC 27609-6504

Mailing address

PO Box 19368
Raleigh, NC 27619-9368
Phone (919) 787-8221

Other identifiers 10

IdentifierTypeStateIssuer
D9130OtherNCMEDCOST
D9131OtherNCMEDCOST
2500018OtherNCUNITED HEALTHCARE
6297819OtherNCCIGNA
138KFOtherNCBLUECROSS BLUESHIELD
P00263266OtherNCRAILROAD MEDICARE
D8898OtherNCMEDCOST
P00258193OtherNCRAILROAD MEDICARE
7146484OtherNCAETNA
89138KFMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20041221000548 NC Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 2062470172 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Nuclear Medicine
Education
Duke University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Radiology Consultants PAGroup PAC ID 4385537992, 59 clinicians
Wake Radiology Diagnostic Imaging Inc.Group PAC ID 5092611863, 66 clinicians

Practice addresses (Care Compare)

3949 Browning PL
Raleigh, NC 27609-6535

3949 Browning PL
Raleigh, NC 27609-6536
Phone (919) 787-7411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.8 of 100Reported as group
Quality
99.47
Improvement activities
40
Cost
83.62

Merit-based Incentive Payment System (MIPS)

Final score
85.29 of 100Reported as group
Quality
82.69
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004-01153NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Radiology Consultants PA Diagnostic Radiology CurrentSince Dec 30, 2004 Accepting new patients
Wake Radiology Diagnostic Imaging Inc. Diagnostic Radiology CurrentSince Dec 30, 2004 Accepting new patients

Locations

3949 Browning Pl
Raleigh, NC 27609
Phone (919) 787-8221

Organizations & group practices 2

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 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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124068432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19368",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276199368",
            "telephone_number": "919-787-8221",
            "fax_number": "919-789-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 BROWNING PL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096504",
            "telephone_number": "919-787-8221",
            "fax_number": "919-789-4461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "RUSSELL",
        "middle_name": "CHAPMAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D9130",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D9131",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2500018",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6297819",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "138KF",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00263266",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D8898",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00258193",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7146484",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89138KF",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.