Organization Active NPI

Wilson Medical Associates PA

  • Internal Medicine Physician
  • Wilson, NC
National Provider Identifier
1497716617
Registry record updated Jun 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WILSON MEDICAL ASSOCIATES PA
Practice address
200 Glendale Drive
Wilson, NC 27893
Phone
(252) 399-0737
Fax
(252) 399-0747
NPI assigned
Mar 29, 2006
Last updated
Jun 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2010

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

Authorized official

Name
Ms. Lorie C Finch
Title
Office Manager
Phone
(252) 399-0737

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

200 Glendale Drive
Wilson, NC 27893

Mailing address

PO Box 7015
Wilson, NC 27895
Phone (252) 399-0737

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100917000420 NC Part B Supplier - Clinic/Group Practice 0941230254 Receives reassigned benefits from 4 practitioners
Practice locations: Wilson, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0895853Wilson Medical Associates PA200 Glendale Drive, Wilson, NC 27893AccreditationSep 3, 2027

National Provider Directory

National Provider Directory

Locations

200 Glendale Dr W
Wilson, NC 27893
Phone (252) 399-0737

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277683200000",
    "number": "1497716617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7015",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "27895",
            "telephone_number": "252-399-0737",
            "fax_number": "252-399-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GLENDALE DRIVE",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "27893",
            "telephone_number": "252-399-0737",
            "fax_number": "252-399-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON MEDICAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2010-06-28",
        "status": "A",
        "authorized_official_last_name": "FINCH",
        "authorized_official_first_name": "LORIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "252-399-0737",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.