Individual provider Active NPI

Bryan Scott Wilson, D.O.

  • Psychiatry Physician
  • Amery, WI
National Provider Identifier
1518329887
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
69464-21 Issued in WI
Practice address
265 Griffin St E
Amery, WI 54001-1439
Phone
(715) 268-8000
NPI assigned
Mar 24, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 63432 MN
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 69464-21 WI Primary

Addresses

Primary practice location

265 Griffin St E
Amery, WI 54001-1439

Mailing address

1564 Selby Ave Apt 8
Saint Paul, MN 55104-6336

Other practice location 1

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 254-4786

Other practice location 2

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-7571

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201008001584 MN Practitioner - Psychiatry 4486946209 Reassigns benefits to 3 organizations
I20201008001886 WI Practitioner - Psychiatry 4486946209 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amery Regional Medical Center IncGroup PAC ID 2769391960, 124 clinicians
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians
Westfields Hospital IncGroup PAC ID 2264490960, 108 clinicians

Practice addresses (Care Compare)

265 Griffin E St
Amery, WI 54001-1439
Phone (715) 268-8000

265 Griffin St E
Amery, WI 54001-1439
Phone (715) 268-8000

403 Stageline Rd
Hudson, WI 54016-7848
Phone (715) 531-6700

405 Stageline Rd
Hudson, WI 54016-7848
Phone (651) 265-1999

411 Stageline Rd
Suite 200
Hudson, WI 54016-7848
Phone (715) 531-6700

535 Hospital Rd
New Richmond, WI 54017-1449
Phone (715) 243-2600

744 E Louisiana St
Saint Croix Falls, WI 54024-9501
Phone (866) 544-6741

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
63432MNMDPsychiatry Physician
69464-21WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Jun 23, 2020 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Jan 12, 2026 Accepting new patients
Group Health, Inc. CurrentSince Jun 23, 2020 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Jul 6, 2020 Accepting new patients
Westfields Hospital, Inc. CurrentSince Jun 1, 2022 Accepting new patients
Westfields Hospital, Inc CurrentSince Jun 1, 2022 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Jul 6, 2020 Accepting new patients
Group Health, Inc. CurrentSince Aug 1, 2025 Accepting new patients

Locations

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

265 Griffin St E
Amery, WI 54001
Phone (715) 268-0301

230 Deronda St
Deronda, WI 54001
Phone (715) 268-0060

535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013

744 E Louisiana St
St Croix Fls, WI 54024
Phone (651) 772-6251

Organizations & group practices 10

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1518329887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1564 SELBY AVE APT 8",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 GRIFFIN ST E",
            "city": "AMERY",
            "state": "WI",
            "postal_code": "540011439",
            "telephone_number": "715-268-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "640 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551012502",
            "country_code": "US",
            "telephone_number": "651-254-4786",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151623",
            "country_code": "US",
            "telephone_number": "612-873-7571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRYAN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-24",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "63432",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "69464-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amery, WI

Sources for this page

Verify at the official NPI Registry.