Active NPI
David Coleman Wilson, M.D.
- Dermatology Physician
- Forest, VA
National Provider Identifier
1194748012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 0101037565
- 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
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 |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080130000557 | VA | Practitioner - Dermatology | 2163504143 |
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 85.15 of 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0101037565 | VA | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virginia Sport & Spine Institute LLC | Current | 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.
-
- Chiropractor
- Forest, VA
- NPI 1902396054
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
- 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.
- 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.