Walter Harris Wilson, DMD, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

6251 Issued in AL

Practice address

2290 Valleydale Rd Ste 100
Birmingham, AL 35244-2113

Phone

(205) 682-1099

NPI assigned

May 13, 2014

Last updated

Apr 19, 2024By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral Surgery

Education

University of Alabama School of Dentistry, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Highfive Omfs Alabama LLC

  dba Alabama Oral and Facial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Birmingham, AL
  • NPI 1831433556
  Medicare reassignment NPD
• Christopher M Rothman, DDS, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Birmingham, AL
  • NPI 1255601324
  NPD (past)

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1407267321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 VALLEYDALE RD STE 100",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352442113",
            "telephone_number": "205-682-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 VALLEYDALE RD STE 100",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352442113",
            "telephone_number": "205-682-1099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "74 Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Pell City",
            "state": "AL",
            "postal_code": "351259370",
            "country_code": "US",
            "telephone_number": "205-338-6688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "WALTER",
        "middle_name": "HARRIS",
        "name_prefix": "Dr.",
        "credential": "DMD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-13",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AL",
            "license": "6251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252782",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251493",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamara Wilson, MS, NBC-HWC
• Theresa Wilson, RN
• Thomas A Wilson Jr., MD
• Tracey Wilson
• Tyshelle Wilson
• Sydney Catherine Wiltz
• Lee T Wimberly, MD
• David R Winchester, DMD
• Susan Winchester, M.D.
• Christina J. Windham, CRNA

• Oral and Maxillofacial Surgery (Dentist) in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.