Organization Active NPI

Wilson Surgical Associates PA

  • Surgery Physician
  • Wilson, NC
National Provider Identifier
1528112802
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
WILSON SURGICAL ASSOCIATES PA
Practice address
130 Glendale Drive West
Wilson, NC 27893-2770
Phone
(252) 399-7557
Fax
(252) 399-1324
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2013

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

Authorized official

Name
Mr. William Thomas Boyd Jr.
Title
Practice Manager/Vice President
Phone
(252) 399-7557

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

130 Glendale Drive West
Wilson, NC 27893-2770

Mailing address

130 Glendale Drive West
Wilson, NC 27893-2770
Phone (252) 399-7557

Other identifiers 1

IdentifierTypeStateIssuer
5917371MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369785600000",
    "number": "1528112802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 GLENDALE DRIVE WEST",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278932770",
            "telephone_number": "252-399-7557",
            "fax_number": "252-399-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 GLENDALE DRIVE WEST",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278932770",
            "telephone_number": "252-399-7557",
            "fax_number": "252-399-1324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON SURGICAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2013-05-29",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRACTICE MANAGER/VICE PRESIDENT",
        "authorized_official_telephone_number": "252-399-7557",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5917371",
            "state": "NC"
        }
    ],
    "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 May 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.