Organization Active NPI

Daniel W Wilson M D PLLC

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Wheeling, WV
National Provider Identifier
1437370970
Registry record updated Jan 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
DANIEL W WILSON M D PLLC
Practice address
7 E Cove Ave
Suite B
Wheeling, WV 26003-5024
Phone
(304) 242-4601
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Daniel W Wilson, MDNPI 1700977592
Title
Owner
Phone
(304) 242-4601

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QH0002X Primary

Addresses

Primary practice location

7 E Cove Ave
Suite B
Wheeling, WV 26003-5024

Mailing address

7 E Cove Ave
Suite B
Wheeling, WV 26003-5024
Phone (304) 242-4601

Other identifiers 2

IdentifierTypeStateIssuer
016687290OtherWVMOUNTAIN STATE BLUE CROSS
DA5379OtherWVRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120130000227 WV Part B Supplier - Clinic/Group Practice 4183881428 Receives reassigned benefits from 3 practitioners
Practice locations: Wheeling, WV

National Provider Directory

National Provider Directory

Locations

7 E Cove Ave
Ste B
Wheeling, WV 26003
Phone (304) 242-4601

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327968000000",
    "number": "1437370970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 E COVE AVE",
            "address_2": "SUITE B",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260035024",
            "telephone_number": "304-242-4601",
            "fax_number": "304-242-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 E COVE AVE",
            "address_2": "SUITE B",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260035024",
            "telephone_number": "304-242-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL W WILSON M D PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2012-01-31",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-242-4601",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNTAIN STATE BLUE CROSS",
            "identifier": "016687290",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA5379",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.