Charles A Wilson, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO1782 Issued in NV

Practice address

6360 Boulder Hwy
Las Vegas, NV 89122-7301

Phone

(725) 228-4520

Fax

(877) 889-5390

NPI assigned

May 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, NV2 enrollments

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 2

Specialty

Family PracticeAlso: Osteopathic Manipulative Medicine

Education

Nova Southeastern College of Osteo Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ridgecrest Regional HospitalGroup PAC ID 9739099896, shared by 9 NPIs, 94 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Compassionate Care Home Health Agency, LLC Home health agency, Fresno, CA, CCN 058233
• Ridgecrest Regional Hospital Hospital, Ridgecrest, CA, CCN 051333

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.wilson@centerwell.eclinicaldirectplus.com

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.

• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593

  Family Medicine

  Medicare reassignment NPD
• Physicians Medical Group of San Jose, Inc.

  dba Physicians Medical Urgent Care, Inc.

  • Internal Medicine Physician
  • San Jose, CA
  • NPI 1891175444

  Family Medicine

  Medicare reassignment NPD
• Ridgecrest Regional Hospital

  • Critical Access Hospital
  • Ridgecrest, CA
  • NPI 1447253125
  Medicare reassignment NPD
• Healthcare Partners Medical Group Coats LTD

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1487631917
  NPD
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Ridgecrest Regional Hospital

  dba Ridgecrest Regional Hospital Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Ridgecrest, CA
  • NPI 1164067971
  NPD
• Ridgecrest Regional Hospital

  dba China Lake Community Health Clinic

  • Rural Health Clinic/Center
  • Ridgecrest, CA
  • NPI 1639448400
  NPD
• Intermountain Medical Holdings Nevada Inc

  dba Intermountain Health

  • Internal Medicine Physician
  • Henderson, NV
  • NPI 1245997279

  Family Medicine

  NPD (past)

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

• Compassionate Care Home Health

  dba Compassionate Care Home Health Agency, LLC

  • Home Health Agency
  • Fresno, CA
  • NPI 1609826387
  Care Compare affiliation
• Ridgecrest Regional Hospital

  • Critical Access Hospital
  • Ridgecrest, CA
  • NPI 1447253125
  Care Compare affiliation
• Ridgecrest Regional Hospital

  • Land Ambulance
  • Ridgecrest, CA
  • NPI 1699398560

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1295781359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 616788",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328616788",
            "telephone_number": "407-533-6836",
            "fax_number": "407-232-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 BOULDER HWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891227301",
            "telephone_number": "725-228-4520",
            "fax_number": "877-889-5390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Jose Figueres Ave Ste 485",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951161597",
            "country_code": "US",
            "telephone_number": "408-259-3022",
            "fax_number": "408-259-3040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHARLES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "DO1782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295781359",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charles.wilson@centerwell.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6360 Boulder Hwy",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891227301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Catherine J Wilson, DPM
• Celie Wilson
• Champagne Wilson
• Chanell La Nette Wilson
• Chanz Wilson
• Charles Christian Wilson III, PHARM.D
• Christopher Wilson, MD
• Christopher James Wilson, PT, DPT
• Cincere Wilson
• Claire Wilson

• Family Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.