Kelsey Rose Wilson, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO52002 Issued in SC

Practice address

169 Ashley Ave. Room 202
Main Hospital MSC 333
Charleston, SC 29425-9125

Phone

(843) 792-3451

NPI assigned

Apr 24, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, MS2 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 2

Specialty

Family Practice

Education

Edward Via Col of Osteo Medicine-Carolinas Campus, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

United Emergency Services of MississippiGroup PAC ID 9739188046, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• BMH-Golden Triangle Hospital, Columbus, MS, CCN 250100

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• United Emergency Services of Mississippi

  • Emergency Medicine Physician
  • Columbus, MS
  • NPI 1801983309
  Medicare reassignment Care Compare group NPD
• App of Tennessee Ed, PLLC

  • Emergency Medicine Physician
  • Maryville, TN
  • NPI 1003230236
  Medicare reassignment NPD
• App of Tennessee HM, PLLC

  • Hospitalist Physician
  • Shelbyville, TN
  • NPI 1396160768
  Medicare reassignment NPD
• Emergency Medical Care Facilities PC

  • Emergency Medicine Physician
  • Jackson, TN
  • NPI 1538345855
  Medicare reassignment NPD
• Relias Emergency Medicine Specialists of Amory, LLC

  • Emergency Medicine Physician
  • Amory, MS
  • NPI 1265074769
  Medicare reassignment NPD
• Relias Emergency Medicine Specialists of West Point, LLC

  • Emergency Medicine Physician
  • West Point, MS
  • NPI 1275172736
  Medicare reassignment NPD
• RH Emergency Medicine of Och Regional LLC

  • Emergency Medicine Physician
  • Starkville, MS
  • NPI 1093532889
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Memorial Hospital - Golden Triangle Inc.

  • General Acute Care Hospital
  • Columbus, MS
  • NPI 1609830173
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1134617335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE. ROOM 202",
            "address_2": "MAIN HOSPITAL MSC 333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-792-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE. ROOM 202",
            "address_2": "MAIN HOSPITAL MSC 333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294259125",
            "telephone_number": "843-792-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KELSEY",
        "middle_name": "ROSE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-24",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "52002",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "DO52002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Lois Reagor Wilson, MSP, CCC-SLP
• Jake Barrett Wilson
• James P Wilson, MD
• Jamie Wilson, MD
• Karen Keene Wilson, PT
• Lindsay Wilson
• Lisa Elaine Wilson, LPC
• M Edward Wilson, MD
• Matthew Alan Wilson, MD
• Meredith Blakeslee Wilson, F.N.P.

• Family Medicine Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.