Charles E. Wilson, MD, PC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

6987 Issued in AL

Legal business name

CHARLES E. WILSON, MD, PC

Practice address

541 W College St
Ste 3500
Florence, AL 35630-5326

Phone

(256) 718-2188

Fax

(256) 718-3363

NPI assigned

Jun 24, 2005

Organization subpart

No

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

Authorized official

Name

Charles Elmo Wilson, MDNPI 1104823202

Title

President

Phone

(256) 718-2188

Specialties & licenses 2

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles E. Wilson, M.D.

  • Urology Physician
  • Florence, AL
  • NPI 1104823202
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300233600000",
    "number": "1174529036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 W COLLEGE ST",
            "address_2": "STE 3500",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356305326",
            "telephone_number": "256-718-2188",
            "fax_number": "256-718-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 W COLLEGE ST",
            "address_2": "STE 3500",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356305326",
            "telephone_number": "256-718-2188",
            "fax_number": "256-718-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES E. WILSON, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2011-03-16",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "ELMO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-718-2188",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "AL",
            "license": "6987",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "MS",
            "license": "15126",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1416173",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529912610",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4042085",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO DMERC",
            "identifier": "4661630001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016248",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DN0441",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51509142",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DH0160",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016288",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4046425",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Florence, AL
• Providers in Florence, AL by specialty
• Urology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.