Active NPI
Charles S Wilson, M.D.
- Ophthalmology Physician
- Farmville, VA
National Provider Identifier
1154338382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 0101031065
- Practice address
- 808 Buffalo St
Farmville, VA 23901-1112 - Phone
- (434) 392-3375
- Fax
- (434) 392-3604
- NPI assigned
- Aug 1, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 0101031065 | VA | Primary |
Addresses
Primary practice location
808 Buffalo St
Farmville, VA 23901-1112
Mailing address
808 Buffalo St
Farmville, VA 23901-1112
Phone (434) 392-3375
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004129 | Other | VA | BLUE CROSS BLUE SHIELD |
| 276995 | Other | SOUTHERN HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101116000694 | VA | Practitioner - Ophthalmology | 6305031360 | Practice locations: Farmville, VA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154338382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 BUFFALO ST",
"city": "FARMVILLE",
"state": "VA",
"postal_code": "239011112",
"telephone_number": "434-392-3375",
"fax_number": "434-392-3604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "808 BUFFALO ST",
"city": "FARMVILLE",
"state": "VA",
"postal_code": "239011112",
"telephone_number": "434-392-3375",
"fax_number": "434-392-3604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CHARLES",
"middle_name": "S",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "VA",
"license": "0101031065",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "004129",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTHERN HEALTH",
"identifier": "276995",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Farmville, VA
- Cherelle Williams Espinoza, BCABA
- Laquita Shaunae Williams, LPC, CSOTP, SAC-S
- Marjorie J Williams, PHYSICAL THERAPIST
- Michelle Renee Williams, RPT
- Ashley Shull Wilson
- Edwina C Wilson, MD
- Tammy Jibben Wingo, F.N.P.
- Women's Osteopathic Medical Care, PLLC
- Women's Osteopathic Medical Care, PLLC
- Alvin Thomas Wood, LPC
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.