Active NPI
Brian Wilson
- Social Worker
- Baltimore, MD
National Provider Identifier
1427536580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 18275
- Practice address
- 5136 Woolverton Ave
Baltimore, MD 21215-5135 - Phone
- (410) 967-6873
- NPI assigned
- Aug 1, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 18275 | MD | Primary |
Addresses
Primary practice location
5136 Woolverton Ave
Baltimore, MD 21215-5135
Mailing address
5136 Woolverton Ave
Baltimore, MD 21215-5135
Phone (410) 967-6873
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7525 Greenway Ctr Dr
Suite 207
Greenbelt, MD 20770-3525
Phone (240) 473-2159
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Active Mindz Therapeutic Services | Current | Accepting new patients | |
| Active Mindz, LLC. | Current | Accepting new patients |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Owings Mills, MD
- NPI 1922787720
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Owings Mills, MD
- NPI 1164138285
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533081600000",
"number": "1427536580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5136 WOOLVERTON AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212155135",
"telephone_number": "410-967-6873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5136 WOOLVERTON AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212155135",
"telephone_number": "410-967-6873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "BRIAN",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-01",
"last_updated": "2018-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker",
"state": "MD",
"license": "18275",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; 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.