Shawn P Wilson, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

031093 Issued in WI

Practice address

1969 W Hart Rd
Beloit, WI 53511

Phone

(608) 758-7215

Fax

(608) 758-3216

NPI assigned

Aug 24, 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 2

Medicare fee-for-service enrollment

Enrolled in IL, WI2 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

Merit-based Incentive Payment System (MIPS)

Final score

85.73 of 100Reported as group

Quality

87.42

Promoting interoperability

100

Improvement activities

40

Cost

65.02

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: swilson262373@direct-ehr-ssmhc.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.

• Southern Wisconsin Emergency Associates SC

  • Emergency Medicine Physician
  • Beloit, WI
  • NPI 1568538189

  IL

  Medicare reassignment NPD
• Stoughton Hospital Association

  • Critical Access Hospital
  • Stoughton, WI
  • NPI 1679558647
  Medicare reassignment NPD
• University of Wisconsin Medical Foundation, Inc

  • Multi-Specialty Clinic/Center
  • Middleton, WI
  • NPI 1598784555
  Medicare reassignment NPD
• Beloit Health System Inc

  • General Practice Physician
  • Roscoe, IL
  • NPI 1841485984
  Medicare reassignment NPD
• Beloit Health System, Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Beloit, WI
  • NPI 1568677417
  NPD
• Stoughton Hospital Association

  • Urgent Care Clinic/Center
  • Cottage Grove, WI
  • NPI 1811733066
  NPD
• Stoughton Hospital Association

  • Medicare Defined Swing Bed Hospital Unit
  • Stoughton, WI
  • NPI 1891869079
  NPD
• University of Wisconsin Medical Foundation, Inc

  • Health Educator
  • Madison, WI
  • NPI 1487414082
  NPD
• Stoughton Hospital Association

  • Urgent Care Clinic/Center
  • McFarland, WI
  • NPI 1477146082
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1356458517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1446 N RANDALL AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535451122",
            "telephone_number": "608-758-7215",
            "fax_number": "608-758-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1969 W HART RD",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "53511",
            "telephone_number": "608-758-7215",
            "fax_number": "608-758-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHAWN",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "031093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31583400",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swilson262373@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "swilson262373@direct-ehr-ssmhc.com",
            "address_1": "1223 E Main St",
            "city": "Perry",
            "state": "MO",
            "country_code": "US",
            "postal_code": "634621410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api.FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1223 E Main St",
            "city": "Perry",
            "state": "MO",
            "country_code": "US",
            "postal_code": "634621410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Malissa R Wightman, RN, APNP
• Wild World Counseling and Coaching,LLC
• Cynthia J Williams
• Kassandra Elizabeth Wilson
• Nancy J. Wilson, M.D.
• Wisconsin CVS Pharmacy LLC
• Wisconsin Therapists LTD.
• Elana Fran Wistrom, DO
• Camryn A Withrow, SAC-IT
• Gretchen R Witowich, MS, RD, LDN

• Emergency Medicine Physician in Beloit, WI
• Providers in Beloit, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.