NPIMap

Individual provider Active NPI

George M Wilson, MD

  • Internal Medicine Physician
  • Williston, ND
National Provider Identifier
1396092219
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12421 Issued in ND
Practice address
1321 W Dakota Pkwy
Williston, ND 58801-3807
Phone
(701) 572-7711
Fax
(701) 572-2283
NPI assigned
Aug 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 12421 ND Primary

Addresses

Primary practice location

1321 W Dakota Pkwy
Williston, ND 58801-3807

Mailing address

PO Box 5010
Minot, ND 58702-5010
Phone (701) 857-5650

Other names 1

  • George M Wilson III Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121024000485 ND Practitioner - Internal Medicine 5799935979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity HealthGroup PAC ID 7911816020, 292 clinicians

Practice addresses (Care Compare)

101 3Rd Ave SW
Minot, ND 58701-3880
Phone (701) 418-8000

2305 37TH Ave SW
Minot, ND 58701-7669
Phone (701) 418-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.05 of 100Reported as group
Quality
60.57
Promoting interoperability
98
Improvement activities
40
Cost
77.93

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health CurrentSince Sep 4, 2012 Accepting new patients
Trinity Health CurrentSince Sep 4, 2012 Accepting new patients
Trinity Hospitals Past Accepting new patients

Locations

101 3rd Ave SW
Minot, ND 58701
Phone (701) 857-5286

1321 W Dakota Pkwy
Williston, ND 58801
Phone (701) 572-7641

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1396092219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5010",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587025010",
            "telephone_number": "701-857-5650",
            "fax_number": "701-857-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 W DAKOTA PKWY",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588013807",
            "telephone_number": "701-572-7711",
            "fax_number": "701-572-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "GEORGE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-09",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ND",
            "license": "12421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GEORGE",
            "last_name": "WILSON",
            "middle_name": "M",
            "suffix": "III",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Williston, ND

Sources for this page

Verify at the official NPI Registry.