Beverly Cecile Wilson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

17916 Issued in SC

Practice address

3817 Main St
Loris, SC 29569-3017

Phone

(843) 663-8000

NPI assigned

Sep 21, 2012

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Little River Medical Center IncGroup PAC ID 2961309315, shared by 7 NPIs, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLeod Loris Hospital Hospital, Loris, SC, CCN 420105

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: beverly.wilson@lrmcenter.eclinicaldirectplus.com

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.

• Little River Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Little River, SC
  • NPI 1629021076

  Family

  Medicare reassignment NPD
• Little River Medical Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Myrtle Beach, SC
  • NPI 1346638483
  Medicare reassignment NPD
• Little River Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Myrtle Beach, SC
  • NPI 1184783284

  Family

  Medicare reassignment NPD
• Little River Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Myrtle Beach, SC
  • NPI 1508120619
  Medicare reassignment NPD
• Little River Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Loris, SC
  • NPI 1619100096

  Family

  Medicare reassignment NPD
• Little River Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Myrtle Beach, SC
  • NPI 1669535225
  Medicare reassignment

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

• McLeod Loris Seacoast Hospital

  • General Acute Care Hospital
  • Loris, SC
  • NPI 1306123344
  Care Compare affiliation

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

{
    "created_epoch": "1348185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1467703157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295660547",
            "telephone_number": "843-663-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3817 MAIN ST",
            "city": "LORIS",
            "state": "SC",
            "postal_code": "295693017",
            "telephone_number": "843-663-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BEVERLY",
        "middle_name": "CECILE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-21",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "17916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP2188",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Summer Watts, FNP
• Matthew G Weeks, M.D.
• Debbie R Williams, LPC
• Myeshia Williams
• Ashley Smith Wilson, P.A.
• David Ephriam Wilson V, PHARMD
• William Rey Worley III, OD
• Valerie D Wright

• Family Nurse Practitioner in Loris, SC
• Providers in Loris, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.