NPIMap

Individual provider Active NPI

Benjamin Montgomery Wilson, MD

  • Diagnostic Radiology Physician
  • Greenville, SC
National Provider Identifier
1316506959
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
94373 Issued in SC
Practice address
1210 W Faris Rd
Greenville, SC 29605-4444
Phone
(864) 522-1800
Fax
(864) 522-1806
NPI assigned
Jun 7, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X D91411 MD
Diagnostic Radiology Physician 2085R0202X 94373 SC Primary
Diagnostic Radiology Physician 2085R0202X LL82423 SC

Addresses

Primary practice location

1210 W Faris Rd
Greenville, SC 29605-4444

Mailing address

300 E McBee Ave Ste 300
Greenville, SC 29601-2899
Phone (864) 522-8611

Other practice location 1

101 E Wood St
Spartanburg, SC 29303-3040
Phone (864) 560-6285

Other practice location 2

600 N Wolfe St
Baltimore, MD 21264-3040
Phone (410) 955-5080

Other identifiers 1

IdentifierTypeStateIssuer
LL82423OtherSCSOUTH CAROLINA LIMITED LICENCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240803000486 DC Practitioner - Diagnostic Radiology 9234469180 Reassigns benefits to 1 organization
I20250824000103 SC Practitioner - Diagnostic Radiology 9234469180 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, shared by 5 NPIs, 2,467 clinicians

Practice addresses (Care Compare)

1210 W Faris Rd
Greenville, SC 29605-4444
Phone (864) 522-1800

1519 Marion St
Columbia, SC 29201-2910
Phone (803) 296-5954

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D91411MDMDDiagnostic Radiology Physician
94373SCMDDiagnostic Radiology Physician
LL82423SCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Imaging Centers, LLC CurrentSince Jan 26, 2026 Accepting new patients
Prisma Health University Medical Group CurrentSince Jul 21, 2025 Accepting new patients
Prisma Health University Medical Group Diagnostic Radiology CurrentSince Jul 21, 2025 Accepting new patients
Johns Hopkins University CurrentSince Jul 1, 2024 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Jan 26, 2026 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Sep 17, 2025 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Feb 9, 2026 Accepting new patients
Prisma Health University Medical Group Diagnostic Radiology CurrentSince Jul 21, 2025 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Jan 26, 2026 Accepting new patients

Locations

600 N Wolfe St
Baltimore, MD 21287

6420 Rockledge Dr
Bethesda, MD 20817
Phone (301) 896-6700

5755 Cedar Ln
Columbia, MD 21044
Phone (410) 381-7171

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

1519 Marion St
Columbia, SC 29201
Phone (803) 296-5513

300 E McBee Ave
Ste 300
Greenville, SC 29601

1210 W Faris Rd
Greenville, SC 29605
Phone (864) 295-4410

Interoperability endpoints

  • Direct secure messaging: bwilson697837@direct.hopkinsmedicine.org
  • Direct secure messaging: bwilson859738@direct.ghs.myhfn.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 56

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

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1316506959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012899",
            "telephone_number": "864-522-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W FARIS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054444",
            "telephone_number": "864-522-1800",
            "fax_number": "864-522-1806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E Wood St",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293033040",
            "country_code": "US",
            "telephone_number": "864-560-6285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 N Wolfe St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212643040",
            "country_code": "US",
            "telephone_number": "410-955-5080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BENJAMIN",
        "middle_name": "MONTGOMERY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-07",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D91411",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "94373",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "LL82423",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH CAROLINA LIMITED LICENCE",
            "identifier": "LL82423",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.