Wilson Medical Associates PA
Organization Active NPI Internal Medicine Physician · Wilson, NC
NPI 1497716617 · NPPES record last updated Jun 28, 2010
Key facts
- NPI
- 1497716617
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 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
- Organization subpart
- No
Authorized official
- Name
- Ms. Lorie C Finch
- Title
- Office Manager
- Phone
- (252) 399-0737
Practitioners 3
-
Charles J Baio, MD
-
Bonnie Ann Boshart, FNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D0895853 | Wilson Medical Associates PA | Accreditation | Sep 3, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100917000420 | NC | Part B Supplier - Clinic/Group Practice | 0941230254 |
Receives reassigned benefits from 4 practitioners Practice locations: Wilson, NC |
National Provider Directory
Locations
200 Glendale Dr W
Wilson, NC 27893
Phone (252) 399-0737
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
200 Glendale Drive
Wilson, NC 27893
Mailing address
PO Box 7015
Wilson, NC 27895
Phone (252) 399-0737
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0291F | Other | NC | BLUE CROSS |
| 890291F | Medicaid | NC |
Other providers in Wilson, NC
- Wilson Heart P a
- Wilson House LLC
- Wilson Imaging Center, LLC
- Wilson Immediate Care, PA
- Wilson Internal Medicine PA
- Wilson Medical Center
- Wilson Medical Center, Inc.
- Wilson Medical Center, Inc.
- Wilson Medical Center, Inc.
- Wilson Medical Center, Inc.
All providers in Wilson, NC · Internal Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.