NPIMap

Individual provider Active NPI

Bradley C Wilson, DO

  • Family Medicine Physician
  • New Lexington, OH
National Provider Identifier
1225020878
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34004144 Issued in OH
Practice address
7756 State Route 37 E
New Lexington, OH 43764-9512
Phone
(740) 342-3540
Fax
(740) 342-3879
NPI assigned
Aug 19, 2005
Last updated
Oct 14, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

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 34004144 OH Primary

Addresses

Primary practice location

7756 State Route 37 E
New Lexington, OH 43764-9512

Mailing address

PO Box 1821
Zanesville, OH 43702-1821
Phone (740) 455-3304

Other identifiers 1

IdentifierTypeStateIssuer
2427136MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20100323000399 OH Practitioner - Family Practice 4789690785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Group of Southeastern Ohio IncGroup PAC ID 8628232469, 61 clinicians

Practice addresses (Care Compare)

7756 State Route 37 E
New Lexington, OH 43764-9512
Phone (740) 455-3304

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4144OHMDRegistered Dietitian
34004144OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Home Primary Care Center Family Medicine Current Accepting new patients

Locations

3620 Court Dr
Ste K
Zanesville, OH 43701
Phone (740) 454-1248

Interoperability endpoints

  • Direct secure messaging: bradley.wilson.p19@direct.pgseo.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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 10

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": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1225020878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1821",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437021821",
            "telephone_number": "740-455-3304",
            "fax_number": "740-455-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7756 STATE ROUTE 37 E",
            "city": "NEW LEXINGTON",
            "state": "OH",
            "postal_code": "437649512",
            "telephone_number": "740-342-3540",
            "fax_number": "740-342-3879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRADLEY",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34004144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2427136",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lexington, OH

Sources for this page

Verify at the official NPI Registry.