Active NPI
Wilson Medical Center, Inc.
- Community Based Hospice Care Agency
- Wilson, NC
National Provider Identifier
1366415630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- License
- HOS0408
- Legal business name
- WILSON MEDICAL CENTER, INC.
- Practice address
- 1705 Tarboro Street ,SW
Wilson, NC 27893-3428 - Phone
- (252) 399-8924
- Fax
- (252) 399-7369
- NPI assigned
- Feb 8, 2006
- Organization subpart
- Yes
- Parent organization
- WILSON MEDICAL CENTER, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Damon D. Sorensen
- Title
- Vice-President & Chief Financial of
- Phone
- (252) 399-8138
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | HOS0408 | NC | Primary |
Addresses
Primary practice location
1705 Tarboro Street ,SW
Wilson, NC 27893-3428
Mailing address
1705 Tarboro Street, SW
Wilson, NC 27893-3428
Phone (252) 399-8924
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3401532 | Medicaid | NC | |
| 0022F | Other | NC | BCBS PROVIDER # |
| 0738150 | Other | NC | CIGNA PROVIDER # |
Other names 1
- Hospice of Wilson Medical Center
National Provider Directory
National Provider Directory- Part of
- Wilson Medical Center Inc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1286496000000",
"number": "1366415630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1705 TARBORO STREET, SW",
"city": "WILSON",
"state": "NC",
"postal_code": "278933428",
"telephone_number": "252-399-8924",
"fax_number": "252-399-7369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 TARBORO STREET ,SW",
"city": "WILSON",
"state": "NC",
"postal_code": "278933428",
"telephone_number": "252-399-8924",
"fax_number": "252-399-7369"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILSON MEDICAL CENTER, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WILSON MEDICAL CENTER, INC.",
"enumeration_date": "2006-02-08",
"last_updated": "2010-10-08",
"status": "A",
"authorized_official_last_name": "SORENSEN",
"authorized_official_first_name": "DAMON",
"authorized_official_middle_name": "D.",
"authorized_official_title_or_position": "VICE-PRESIDENT & CHIEF FINANCIAL OF",
"authorized_official_telephone_number": "252-399-8138",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "NC",
"license": "HOS0408",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3401532",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER #",
"identifier": "0022F",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PROVIDER #",
"identifier": "0738150",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Hospice of Wilson Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Wilson, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.