Active NPI
Bradley James Willson
- Clinical Neuropsychologist
- Chapel Hill, NC
National Provider Identifier
1477489201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 613
- Practice address
- 101 Manning Dr
Chapel Hill, NC 27514-4220 - Phone
- (984) 974-1686
- NPI assigned
- Jun 19, 2026
- 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 |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 613 | NC | Primary |
Addresses
Primary practice location
101 Manning Dr
Chapel Hill, NC 27514-4220
Mailing address
4501 Ashmont CT
Raleigh, NC 27616-7811
Phone (317) 626-5504
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1781827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781827200000",
"number": "1477489201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4501 ASHMONT CT",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276167811",
"telephone_number": "317-626-5504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 MANNING DR",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "275144220",
"telephone_number": "984-974-1686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLSON",
"first_name": "BRADLEY",
"middle_name": "JAMES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-06-19",
"last_updated": "2026-06-19",
"certification_date": "2026-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Clinical Neuropsychologist",
"state": "NC",
"license": "613",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chapel Hill, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.