Russell Andrew Wilson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

040590 Issued in GA

Practice address

1265 Highway 54 W Ste 500B
Fayetteville, GA 30214-4556

Phone

(770) 719-5660

Fax

(678) 336-5955

NPI assigned

Jul 19, 2005

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

Other names 1

• Russell A Wilson Professional name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

University of Texas Southwestern Medical School at Dallas, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Specialty Hospital Billing LLCGroup PAC ID 4183986490, 252 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Peachtree City, GA, CCN 117137
• Central Home Health Care, an Amedisys Company Home health agency, Douglasville, GA, CCN 117050
• Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215
• Piedmont Mountainside Hospital Inc Hospital, Jasper, GA, CCN 110225
• Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191

Merit-based Incentive Payment System (MIPS)

Final score

91.62 of 100Reported as apm

Quality

83.25

Promoting interoperability

100

Improvement activities

40

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 and National Provider Directory roles.

• Piedmont Specialty Hospital Billing LLC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1699290510
  Medicare reassignment Care Compare group NPD
• Piedmont Athens Specialty Care LLC

  • Cardiovascular Disease Physician
  • Athens, GA
  • NPI 1184130627

  Surgery

  Medicare reassignment NPD
• Piedmont Providers LLC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1548273592
  Medicare reassignment NPD

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

• Amedisys Georgia, LLC

  dba Central Home Health Care, an Amedisys Company

  • Home Health Agency
  • Douglasville, GA
  • NPI 1437117090
  Care Compare affiliation
• CHMG of Griffin, LLC

  dba Centerwell Home Health

  • Home Health Agency
  • Peachtree City, GA
  • NPI 1730119538
  Care Compare affiliation
• Fayette Community Hospital, Inc.

  dba Piedmont Fayette Hospital

  • General Acute Care Hospital
  • Fayetteville, GA
  • NPI 1528027240
  Care Compare affiliation
• Piedmont Henry Hospital, Inc.

  • General Acute Care Hospital
  • Stockbridge, GA
  • NPI 1225034333
  Care Compare affiliation
• Piedmont Mountainside Hospital, Inc.

  dba Piedmont Mountainside Hospital

  • General Acute Care Hospital
  • Jasper, GA
  • NPI 1780643411
  Care Compare affiliation

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1427057736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 HIGHWAY 54 W",
            "address_2": "SUITE 500B",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144548",
            "telephone_number": "770-719-5660",
            "fax_number": "678-817-4339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 HIGHWAY 54 W STE 500B",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144556",
            "telephone_number": "770-719-5660",
            "fax_number": "678-336-5955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 Newnan Crossing Blvd E Ste 100",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302652409",
            "country_code": "US",
            "telephone_number": "770-400-7850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "RUSSELL",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "040590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00711389C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00081030",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUSSELL",
            "last_name": "WILSON",
            "middle_name": "A",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Wayne Williams, MD
• Amy Williamson, PT
• Miecha Y Willis
• Holly Willock
• Kimberly Anne Wilmoth, APRN, FNP-C
• Virginia Wilson
• Zachary Wilson, DMD
• Warnitra Wimberly, PHARMD
• David Lee Winfrey, D.C.
• Lloyd Thomas Winger IV, MD

• Surgery Physician in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.