Robert Kent Wilson, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036154030 Issued in IL

Practice address

27100 Chardon Rd
University Hospitals Richmond Medical Center
Richmond Heights, OH 44143

Phone

(216) 844-8447

NPI assigned

Jun 13, 2017

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 IL

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

Specialty

Internal Medicine

Education

Lake Erie Col of Osteo Med at Seton Hill Univ, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD

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

• Endeavor Health Clinical Operations

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1184670549
  Care Compare affiliation

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1285164277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 WAUKEGAN RD STE 200",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600932724",
            "telephone_number": "847-242-6600",
            "fax_number": "847-242-6605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27100 CHARDON RD",
            "address_2": "UNIVERSITY HOSPITALS RICHMOND MEDICAL CENTER",
            "city": "RICHMOND HEIGHTS",
            "state": "OH",
            "postal_code": "44143",
            "telephone_number": "216-844-8447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 Waukegan Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Northfield",
            "state": "IL",
            "postal_code": "600932724",
            "country_code": "US",
            "telephone_number": "847-242-6600",
            "fax_number": "847-242-6605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ROBERT",
        "middle_name": "KENT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-13",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036154030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monique Williams, CNP
• Sabrina Renee Williams
• Tana Darniece Williams, APRN
• Wilson-Rich, LLC
• Eric Carl Wilson, H.I.S.
• Gregory Winston II
• Jon Winston
• Janine Wong, DO
• Patricia Woodruff
• Walter Woodruff, DO

• Internal Medicine Physician in Richmond Heights, OH
• Providers in Richmond Heights, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.