David Brent Wilson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9106539 Issued in FL

Practice address

3334 Capital Medical Blvd Ste 400
Tallahassee, FL 32308

Phone

(850) 877-8174

Fax

(850) 877-5636

NPI assigned

May 12, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, FL, SC3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Merit-based Incentive Payment System (MIPS)

Final score

76.5 of 100Reported as group

Quality

47.27

Promoting interoperability

99

Improvement activities

40

Cost

75.24

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Tallahassee Orthopedic Clinic III PL

  • Medical Specialty Clinic/Center
  • Tallahassee, FL
  • NPI 1194778050

  GA

  Medicare reassignment NPD
• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217
  Medicare reassignment
• Tallahassee Orthopedic Clinic III, P.L.

  • Durable Medical Equipment & Medical Supplies
  • Panama City Beach, FL
  • NPI 1497617948
  NPD
• Baptist Easley

  • Hospitalist Physician
  • Easley, SC
  • NPI 1154859031

  Physician Assistant

  NPD
• Prisma Health University Medical Group

  • Gynecology Physician
  • Greer, SC
  • NPI 1003619313
  NPD

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1205003043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 CAPITAL MEDICAL BLVD STE 400",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084470",
            "telephone_number": "850-877-8174",
            "fax_number": "850-877-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3334 CAPITAL MEDICAL BLVD STE 400",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "32308",
            "telephone_number": "850-877-8174",
            "fax_number": "850-877-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DAVID",
        "middle_name": "BRENT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-12",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "5330",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wilson Family Medicine LLC
• Amy Nicole Wilson
• Brian Guy Wilson, M.D.
• Cindy Karen Wilson, ARNP
• D'Vonshay Wilson, RBT
• Irene Bahmann Wilson, ARNP
• Jo Ann Wilson, RN
• Jodi Wilson, MD
• Kathleen P. Wilson, PHD,CPNP, FNP-BC
• Lajasmaine Wilson

• Physician Assistant in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.

Verify at the official NPI Registry.