NPIMap

Individual provider Active NPI

Brent Wilson, MD

  • Family Medicine Physician
  • Fresno, CA
National Provider Identifier
1184647091
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A842540 Issued in CA
Practice address
199 W Shields Ave
Fresno, CA 93705-4102
Phone
(559) 225-4706
Fax
(559) 225-4710
NPI assigned
Jul 25, 2006
Last updated
Sep 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A842540 CA Primary

Addresses

Primary practice location

199 W Shields Ave
Fresno, CA 93705-4102

Mailing address

199 W Shields Ave
Fresno, CA 93705-4102
Phone (559) 225-4706

Other identifiers 4

IdentifierTypeStateIssuer
00A842540OtherCABLUE SHIELD
00A842540MedicaidCA
A84254OtherCOUNTY OF FRESNO
A84254OtherCABLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050809001114 CA Practitioner - General PracticePractitioner - Family Practice 8426087453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Creighton University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Valley Urgent Care Medical Group IncGroup PAC ID 8022901933, 6 clinicians

Practice addresses (Care Compare)

199 W Shields Ave
Fresno, CA 93705-4102
Phone (559) 225-4706

4177 W Shaw Ave
Suite 107
Fresno, CA 93722-6221
Phone (559) 225-4706

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A84254CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Valley Urgent Care Medical Group Inc Family Medicine CurrentSince Apr 1, 2006 Accepting new patients
Senior Care Medical Providers Inc PastSince Jul 28, 2025 Accepting new patients
North Fresno Emergency Physicians Medical Group Emergency Medicine Past Accepting new patients
Total Life Change Inc Past Accepting new patients

Locations

199 W Shields Ave
Fresno, CA 93705
Phone (559) 225-4706

4177 W Shaw Ave
Ste 107
Fresno, CA 93722
Phone (559) 225-4706

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11784/brand/1/csg/1/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Compassionate Care Home Health Agency, LLCFresno, CA, CCN 058233 Home health agency Corporate Director Sep 17, 2016
Compassionate Care Hospice Central California LLCFresno, CA, CCN A01798 Hospice Contracted Managing Employee Jul 1, 2019
Smart Choice Hospice IncChatsworth, CA, CCN A11536 Hospice Contracted Managing Employee Nov 1, 2025
Healthcare California HospiceFresno, CA, CCN B21651 Hospice W-2 Managing Employee Jan 5, 2026
Ardent Hospice of the ValleyDelano, CA, CCN A01585 Hospice W-2 Managing Employee Aug 16, 2022

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1184647091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 W SHIELDS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937054102",
            "telephone_number": "559-225-4706",
            "fax_number": "559-225-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 W SHIELDS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937054102",
            "telephone_number": "559-225-4706",
            "fax_number": "559-225-4710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRENT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A842540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A842540",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A842540",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNTY OF FRESNO",
            "identifier": "A84254",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "A84254",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.