NPIMap

Individual provider Active NPI

Scott Wilson, MD

  • Family Medicine Physician
  • Lincoln, NE
National Provider Identifier
1194733451
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21493 Issued in NE
Practice address
4501 S 70TH St
Ste 130
Lincoln, NE 68516-4282
Phone
(402) 484-5100
Fax
(402) 484-5151
NPI assigned
Aug 3, 2006
Last updated
Feb 26, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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 21493 NE Primary

Addresses

Primary practice location

4501 S 70TH St
Ste 130
Lincoln, NE 68516-4282

Mailing address

8055 O St
Ste 300
Lincoln, NE 68510-2580
Phone (402) 421-0896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20050727000142 NE Practitioner - Family Practice 9032147541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Lincoln Family Physicians PCGroup PAC ID 7214911270, 15 clinicians

Practice addresses (Care Compare)

4424 S 86TH St
Lincoln, NE 68526-9225
Phone (402) 483-2987

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21493NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Lincoln Family Physicians, PC Family Medicine CurrentSince Oct 1, 2019 Accepting new patients
South Lincoln Family Physicians, PC Family Medicine PastSince Oct 1, 2019 Accepting new patients
Crete Area Medical Center Family Medicine Past Accepting new patients
Lincoln Physician Network LLC Past Accepting new patients

Locations

3201 Pioneers Blvd
Ste 304
Lincoln, NE 68502
Phone (402) 483-2987

4130 Pioneer Woods Dr
Ste 2
Lincoln, NE 68506
Phone (402) 483-2987

4424 S 86th St
Lincoln, NE 68526
Phone (402) 483-2987

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 7

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1194733451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8055 O ST",
            "address_2": "STE 300",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102580",
            "telephone_number": "402-421-0896",
            "fax_number": "402-421-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 S 70TH ST",
            "address_2": "STE 130",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164282",
            "telephone_number": "402-484-5100",
            "fax_number": "402-484-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "21493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.