NPIMap

Individual provider Active NPI

Robin A. Wilson, D.O.

  • Internal Medicine Physician
  • Simpsonville, SC
National Provider Identifier
1437190683
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0727 Issued in SC
Practice address
205 North Maple Street
Suite 8
Simpsonville, SC 29681
Phone
(864) 963-9149
Fax
(864) 967-4727
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2022

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 0727 SC Primary

Addresses

Primary practice location

205 North Maple Street
Suite 8
Simpsonville, SC 29681

Mailing address

PO Box 81055
Simpsonville, SC 29680-0018
Phone (864) 963-9149

Other identifiers 5

IdentifierTypeStateIssuer
007272MedicaidSC
576007863071OtherSCBLUECHOICE HEALTHPLAN ID
6980369OtherSCCIGNA ID
7268402OtherSCAETNA ID
576007863095OtherSCBCBS OF SC ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20031212000462 SC Practitioner - Internal Medicine 7012813694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 1997
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

205 N Maple St
Suite 8
Simpsonville, SC 29681-2312
Phone (864) 963-9149

PO Box
Suite 81055
Simpsonville, SC 29680-0018

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0727SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Robin a. Wilson and Associates, LLC Internal Medicine CurrentSince Nov 12, 2007 Accepting new patients
Greenville Health System Past Accepting new patients

Locations

205 N Maple St
Ste 8
Simpsonville, SC 29681
Phone (864) 963-9149

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1437190683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81055",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296800018",
            "telephone_number": "864-963-9149",
            "fax_number": "864-967-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 NORTH MAPLE STREET",
            "address_2": "SUITE 8",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "29681",
            "telephone_number": "864-963-9149",
            "fax_number": "864-967-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ROBIN",
        "middle_name": "A.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "0727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007272",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECHOICE HEALTHPLAN ID",
            "identifier": "576007863071",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA ID",
            "identifier": "6980369",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID",
            "identifier": "7268402",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF SC ID",
            "identifier": "576007863095",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

Verify at the official NPI Registry.