Individual provider Active NPI

Michelle Margarita Wilson, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Greenville, SC
National Provider Identifier
1235255266
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
27103 Issued in SC
Practice address
200 Patewood Dr Ste C100
Greenville, SC 29615-6322
Phone
(864) 454-7422
Fax
(864) 454-8265
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 27103 SC Primary
Family Medicine Physician 207Q00000X 27103 SC

Addresses

Primary practice location

200 Patewood Dr Ste C100
Greenville, SC 29615-6322

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other identifiers 1

IdentifierTypeStateIssuer
271039MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mwilson5665@direct.ghs.myhfn.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20090210000803 SC Practitioner - Sports MedicinePractitioner - Family Practice 8820153695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Indiana University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

200 Patewood Dr
Suite C100
Greenville, SC 29615-6322
Phone (864) 454-7422

210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123

300 E McBee Ave
Greenville, SC 29601-2842
Phone (864) 797-6220

300 E McBee Ave FL
Suite 4
Greenville, SC 29601-2842

Hospital & facility affiliations

  • St Francis-Downtown Hospital, Greenville, SC, CCN 420023
  • Prisma Health Patewood Hospital Hospital, Greenville, SC, CCN 420102
  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078
  • Prisma Health Baptist Easley Hospital Hospital, Easley, SC, CCN 420015
  • Prisma Health Greer Memorial Hospital Hospital, Spartanburg, SC, CCN 420033
  • Prisma Health North Greenville Ltach Long-term care hospital, Travelers Rest, SC, CCN 422008

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Family Medicine Current Accepting new patients
Prisma Health University Medical Group CurrentSince Nov 10, 2009 Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

200 Patewood Dr
Ste C100
Greenville, SC 29615
Phone (864) 454-7422

100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

200 Patewood Dr
Ste B460
Greenville, SC 29615
Phone (864) 454-2226

877 W Faris Rd
Ste C
Greenville, SC 29605
Phone (864) 455-8147

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

200 Patewood Dr
Bldg A
Greenville, SC 29615
Phone (864) 454-2604

315 Medical Pkwy
Ste 200
Greer, SC 29650
Phone (864) 797-9550

719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Organizations & group practices 2

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.

Hospital & facility affiliations 60

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1235255266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR STE C100",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156322",
            "telephone_number": "864-454-7422",
            "fax_number": "864-454-8265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHELLE",
        "middle_name": "MARGARITA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "SC",
            "license": "27103",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "27103",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271039",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwilson5665@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mwilson5665@direct.ghs.myhfn.org",
            "address_1": "200 Patewood Dr Ste C100",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296156322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.