NPIMap

Individual provider Active NPI

Darryel Alexander Wilson, MD

  • Family Medicine Physician
  • Covington, GA
National Provider Identifier
1285291286
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
95240 Issued in GA
Practice address
14779 Brown Bridge Rd
Covington, GA 30016-4127
Phone
(770) 788-7777
NPI assigned
May 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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 95240 GA Primary

Addresses

Primary practice location

14779 Brown Bridge Rd
Covington, GA 30016-4127

Mailing address

2465 Wall St SE
Conyers, GA 30013-6342
Phone (770) 231-9413

Other practice location 1

1120 15th St
Augusta, GA 30912-0004
Phone (706) 721-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20230511000535 GA Practitioner - Family Practice 5799015483 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

105 Collier Rd NW
Suite 5020
Atlanta, GA 30309-1731
Phone (404) 367-3210

1280 Dogwood Dr SE
Conyers, GA 30013-5046
Phone (404) 994-4662

14779 Brown Bridge Rd
Covington, GA 30016-4127
Phone (770) 788-7777

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

Hospital & facility affiliations

  • Bridgeway Home Health Home health agency, Conyers, GA, CCN 117111
  • Amedisys Home Health of Covington Home health agency, Covington, GA, CCN 117065
  • Central Home Health Care, an Amedisys Company Home health agency, Tucker, GA, CCN 117026
  • Piedmont Rockdale Hospital Hospital, Conyers, GA, CCN 110091
  • Piedmont Newton Hospital Hospital, Covington, GA, CCN 110018

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet of Georgia PC CurrentSince Oct 15, 2023 Accepting new patients
Piedmont Medical Care Corporation Family Medicine CurrentSince May 3, 2023 Accepting new patients
Piedmont Providers LLC Past Accepting new patients

Locations

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

2292 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 382-9941

14779 Brown Bridge Rd
Covington, GA 30016
Phone (770) 788-7777

Organizations & group practices 4

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 5

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": "1558656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1285291286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2465 WALL ST SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136342",
            "telephone_number": "770-231-9413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14779 BROWN BRIDGE RD",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300164127",
            "telephone_number": "770-788-7777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 15th St",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309120004",
            "country_code": "US",
            "telephone_number": "706-721-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DARRYEL",
        "middle_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-24",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "95240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, GA

Sources for this page

Verify at the official NPI Registry.