Carol Wilson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME79468 Issued in FL

Practice address

601 5TH St S
Dept 6590
St Petersburg, FL 33701-4804

Phone

(727) 767-7739

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: cwilson203868@direct.unc.nchie.net

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.

• Caldwell Memorial Hospital, Inc

  • Pediatrics Physician
  • Lenoir, NC
  • NPI 1922013457
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1376561415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 5TH ST S",
            "address_2": "DEPT 6590",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014804",
            "telephone_number": "727-767-7739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 5TH ST S",
            "address_2": "DEPT 6590",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014804",
            "telephone_number": "727-767-7739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CAROL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME79468",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200700845",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "78648",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891451E",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125195254A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265213700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Willow Bay Counseling
• Wilmas Companions Home Care
• Michael John Wilsey, MD
• Vixen A Wilson-Thomas, SLP
• Bobbie Raylene Wilson, MSN, ARNP, FNP-C
• Carole Louise Wilson, PHARM D
• Christopher H Wilson, D.O.
• Darius Wilson Sr., CBHT
• Elizabeth Wilson, DOM, RD
• Jamie Wilson IV, APRN

• Pediatrics Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.