Active NPI
Victor Warren Wilson, MD
- Orthopaedic Surgery Physician
- Springfield, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 35088284
- Practice address
- 1229 E Seminole St
Suite 230
Springfield, MO 65804-2227 - Phone
- (417) 820-5610
- Fax
- (417) 820-5589
- NPI assigned
- Aug 8, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 35088284 | OH | Primary |
Addresses
Primary practice location
1229 E Seminole St
Suite 230
Springfield, MO 65804-2227
Mailing address
PO Box 505164
Saint Louis, MO 63150-5164
Phone (417) 829-4620
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 204922801 | Medicaid | MO | |
| 171572001 | Medicaid | AR | |
| 431560263 | Other | TRICARE WEST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- Saint Louis University School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Clinic Springfield Communities
Practice addresses (Care Compare)
1235 E Cherokee St
Springfield, MO 65804-2203
1605 Martin Springs Dr
Rolla, MO 65401-2980
2115 S Fremont Ave
3050 MC Infectious Disease Whiteside
Springfield, MO 65804-2236
Phone (417) 820-3905
3050 E River Bluff Blvd
MC Orthopedics
Ozark, MO 65721-8807
Phone (417) 820-5610
Hospital & facility affiliations
- Mercy Hospital Springfield
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 11 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 44 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35088284 | OH | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
3050 E River Bluff Blvd
Ozark, MO 65721
Phone (417) 820-5610
1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379
1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379
620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215
2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905
Interoperability endpoints
- vwilson18518@directc.mercy.net
- vwilson993@directb.mercy.net
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Springfield, MO
- NPI 1245277631
-
- Rural Health Clinic/Center
- Willow Springs, MO
- NPI 1972771657
-
- Rural Health Clinic/Center
- Lebanon, MO
- NPI 1447389127
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Springfield, MO
- NPI 1578504056
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412294400000",
"number": "1528078136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 505164",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631505164",
"telephone_number": "417-829-4620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1229 E SEMINOLE ST",
"address_2": "SUITE 230",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658042227",
"telephone_number": "417-820-5610",
"fax_number": "417-820-5589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "VICTOR",
"middle_name": "WARREN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2014-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "OH",
"license": "35088284",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "204922801",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "171572001",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE WEST",
"identifier": "431560263",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.