Active NPI
Charles Stephen Wilson, M.D
- Cardiovascular Disease Physician
- Lincoln, NE
National Provider Identifier
1487859658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 12283
- Practice address
- 1500 S 48TH St
Lincoln, NE 68506-1225 - Phone
- (402) 481-8944
- NPI assigned
- Jun 18, 2007
- 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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 12283 | NE | Primary |
Addresses
Primary practice location
1500 S 48TH St
Lincoln, NE 68506-1225
Mailing address
7430 N Hampton Rd
Lincoln, NE 68506-1624
Phone (402) 488-9181
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12283 | NE | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nebraska Heart Institute PC | Cardiovascular Disease | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Cardiovascular Disease Physician
- Lincoln, NE
- NPI 1336125202
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487859658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7430 N HAMPTON RD",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685061624",
"telephone_number": "402-488-9181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 S 48TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685061225",
"telephone_number": "402-481-8944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CHARLES",
"middle_name": "STEPHEN",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NE",
"license": "12283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.