Individual provider Active NPI

Stanley A Wilkins, MD

  • Otolaryngology Physician
  • Raleigh, NC
National Provider Identifier
1295783199
Registry record updated Aug 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
27412 Issued in NC
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

Updated by the provider on Aug 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
040002668OtherNCRAILROAD MEDICARE
87479OtherNCBLUE CROSS
8987479MedicaidNC
1050140OtherNCUNITED 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031209000040 NC Practitioner - Otolaryngology 9931005204 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Capitol Ear, Nose, and Throat Otolaryngology CurrentSince Jul 1, 2012 Accepting new patients
Capitol Ear, Nose & Throat PastSince Jul 1, 2012 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.