Individual provider Active NPI

David Coleman Wilson, M.D.

  • Dermatology Physician
  • Forest, VA
National Provider Identifier
1194748012
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101037565 Issued in VA
Practice address
2203 Graves Mill Rd
Suite a
Forest, VA 24551-4296
Phone
(434) 385-1982
Fax
(434) 385-1985
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 0101037565 VA Primary

Addresses

Primary practice location

2203 Graves Mill Rd
Suite a
Forest, VA 24551-4296

Mailing address

2203 Graves Mill Rd
Suite a
Forest, VA 24551-4296
Phone (434) 385-1982

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080130000557 VA Practitioner - Dermatology 2163504143

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
77.98
Promoting interoperability
86
Improvement activities
40
Cost
84.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101037565VAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Sport & Spine Institute LLC CurrentSince Aug 1, 2018 Accepting new patients

Locations

2203 Graves Mill Rd
Ste A
Forest, VA 24551
Phone (434) 385-1982

Organizations & group practices 1

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

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": "1183852800000",
    "number": "1194748012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 GRAVES MILL RD",
            "address_2": "SUITE A",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245514296",
            "telephone_number": "434-385-1982",
            "fax_number": "434-385-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 GRAVES MILL RD",
            "address_2": "SUITE A",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245514296",
            "telephone_number": "434-385-1982",
            "fax_number": "434-385-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DAVID",
        "middle_name": "COLEMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101037565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest, VA

Sources for this page

Verify at the official NPI Registry.