NPIMap

Individual provider Active NPI

Timothy J Wilson, D.O

  • Internal Medicine Physician
  • Wheeling, WV
National Provider Identifier
1407892631
Registry record updated Apr 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2098 Issued in WV
Practice address
1132 National Rd
Wheeling, WV 26003-5940
Phone
(304) 242-1032
Fax
(304) 242-6341
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2017

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 2098 WV Primary

Addresses

Primary practice location

1132 National Rd
Wheeling, WV 26003-5940

Mailing address

2000 Eoff St
Wheeling, WV 26003-3823
Phone (304) 234-8663

Other identifiers 2

IdentifierTypeStateIssuer
2665272MedicaidOH
3810005848MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20060727000005 WV Practitioner - Internal Medicine 1355354291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia School of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reynolds Memorial Hospital, IncGroup PAC ID 9830184530, 152 clinicians

Practice addresses (Care Compare)

426 8TH St
Glen Dale, WV 26038-1451

800 Wheeling Ave
Glen Dale, WV 26038-1660
Phone (304) 843-3307

Hospital & facility affiliations

  • Wvuhs Home Care Home health agency, Clarksburg, WV, CCN 517053
  • Adoration Home Health Home health agency, Morgantown, WV, CCN 517122
  • Reynolds Memorial Hospital, Inc Hospital, Glen Dale, WV, CCN 510013
  • Wheeling Hospital, Inc Hospital, Wheeling, WV, CCN 510050
  • Wetzel County Hospital Hospital, New Martinsville, WV, CCN 510072
  • Good Shepherd Nursing Home Nursing home, Wheeling, WV, CCN 515038
  • Continuous Care Center Wheeling Hospital Nursing home, Wheeling, WV, CCN 515055

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Reynolds Memorial Hospital Inc Internal Medicine CurrentSince Nov 1, 2019 Accepting new patients
Reynolds Memorial Hospital, Inc CurrentSince Nov 1, 2019 Accepting new patients

Locations

800 Wheeling Ave
Glen Dale, WV 26038
Phone (304) 221-4520

2000 Eoff St
Wheeling, WV 26003
Phone (304) 234-0123

Interoperability endpoints

  • Direct secure messaging: twilson146572@direct.wvuhsdirect.com

Organizations & group practices 2

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 6

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1407892631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 EOFF ST",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033823",
            "telephone_number": "304-234-8663",
            "fax_number": "304-234-8960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 NATIONAL RD",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260035940",
            "telephone_number": "304-242-1032",
            "fax_number": "304-242-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "2098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2665272",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810005848",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

Verify at the official NPI Registry.