Active NPI
Stanley A Wilkins, MD
- Otolaryngology Physician
- Raleigh, NC
National Provider Identifier
1295783199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 27412
- Practice address
- 4600 Lake Boone Trail
Suite 100
Raleigh, NC 27607-7529 - Phone
- (919) 787-1374
- Fax
- (919) 571-8135
- NPI assigned
- May 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 27412 | NC | Primary |
Addresses
Primary practice location
4600 Lake Boone Trail
Suite 100
Raleigh, NC 27607-7529
Mailing address
4600 Lake Boone Trail
Suite 100
Raleigh, NC 27607-7529
Phone (919) 787-1374
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 040002668 | Other | NC | RAILROAD MEDICARE |
| 87479 | Other | NC | BLUE CROSS |
| 8987479 | Medicaid | NC | |
| 1050140 | Other | NC | UNITED HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Raleigh Capitol Ear, Nose, and Throat | Otolaryngology | Current | Accepting new patients |
| Capitol Ear, Nose & Throat | Past | Accepting new patients |
Locations
4600 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 787-1374
4600 Lake Boone Trl
Ste 100
Raleigh, NC 27607
Phone (919) 420-2027
Interoperability endpoints
- swilkins@rcent1294.srs-direct.com
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.
-
- Otolaryngology Physician
- Raleigh, NC
- NPI 1902170442
-
- Otolaryngology/Facial Plastic Surgery Physician
- Raleigh, NC
- NPI 1477554327
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344211200000",
"number": "1295783199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4600 LAKE BOONE TRAIL",
"address_2": "SUITE 100",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276077529",
"telephone_number": "919-787-1374",
"fax_number": "919-571-8135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 LAKE BOONE TRAIL",
"address_2": "SUITE 100",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276077529",
"telephone_number": "919-787-1374",
"fax_number": "919-571-8135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKINS",
"first_name": "STANLEY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-04",
"last_updated": "2012-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NC",
"license": "27412",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "040002668",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "87479",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8987479",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1050140",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.