Active NPI
Gerald A Wilson, M.D.
- Surgery Physician
- Columbia, SC
National Provider Identifier
1144259763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 7887
- Practice address
- 1701 Saint Julian PL
Suite 100
Columbia, SC 29204-2418 - Phone
- (803) 254-0814
- Fax
- (803) 256-1191
- NPI assigned
- Jul 3, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 7887 | SC | Primary |
Addresses
Primary practice location
1701 Saint Julian PL
Suite 100
Columbia, SC 29204-2418
Mailing address
1701 Saint Julian PL
Suite 100
Columbia, SC 29204-2418
Phone (803) 254-0814
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7887 | SC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144259763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 SAINT JULIAN PL",
"address_2": "SUITE 100",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292042418",
"telephone_number": "803-254-0814",
"fax_number": "803-256-1191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 SAINT JULIAN PL",
"address_2": "SUITE 100",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292042418",
"telephone_number": "803-254-0814",
"fax_number": "803-256-1191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "GERALD",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "SC",
"license": "7887",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.