Active NPI
Gregory Wilson, PHARMD
- Pharmacist
- Bennington, VT
National Provider Identifier
1124628623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 033.0088946
- Practice address
- 212 Northside Dr
Bennington, VT 05201-1723 - Phone
- (802) 442-6822
- Fax
- (802) 442-8356
- NPI assigned
- Oct 26, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 033.0088946 | VT | Primary |
Addresses
Primary practice location
212 Northside Dr
Bennington, VT 05201-1723
Mailing address
308 Crescent Blvd
Bennington, VT 05201-2419
Phone (208) 869-1890
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 033.0088946 | VT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East LP | Current | Accepting new patients |
Organizations & group practices 1
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.
-
dba Wal-Mart Pharmacy 10-2289
- Community/Retail Pharmacy
- Bennington, VT
- NPI 1245257443
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603670400000",
"number": "1124628623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 CRESCENT BLVD",
"city": "BENNINGTON",
"state": "VT",
"postal_code": "052012419",
"telephone_number": "208-869-1890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 NORTHSIDE DR",
"city": "BENNINGTON",
"state": "VT",
"postal_code": "052011723",
"telephone_number": "802-442-6822",
"fax_number": "802-442-8356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "GREGORY",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-26",
"last_updated": "2020-10-26",
"certification_date": "2020-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VT",
"license": "033.0088946",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bennington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.