Individual provider Active NPI

Chester Wilson Jr., MD

  • Radiation Oncology Physician
  • Wyoming, MI
National Provider Identifier
1548245772
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
4301508350 Issued in MI
Practice address
5950 Metro Way SW
Wyoming, MI 49519-9514
Phone
(616) 252-8180
NPI assigned
Dec 9, 2005
Last updated
Oct 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 01064288A IN
Radiation Oncology Physician 2085R0001X 4301508350 MI Primary

Addresses

Primary practice location

5950 Metro Way SW
Wyoming, MI 49519-9514

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

1668 S US Highway 421
Westville, IN 46391-9523
Phone (800) 860-8100

Other identifiers 2

IdentifierTypeStateIssuer
1548245712MedicaidMI
200882630MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230629002447 MI Practitioner - Radiation Oncology 8325020811 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of California, San Francisco School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Michigan Radiation OncologyGroup PAC ID 7810053550, 2 clinicians

Practice addresses (Care Compare)

5950 Metro Way SW
Metro Health Cancer Center
Wyoming, MI 49519-9514
Phone (616) 252-8180

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01064288AINMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group CurrentSince Nov 1, 2023 Accepting new patients
West Michigan Radiation Oncology Radiation Oncology CurrentSince Oct 31, 2023 Accepting new patients
Advantage Health/Saint Mary's Medical Group Current Accepting new patients
Johnson Family Center for Cancer Care CurrentSince Jul 31, 2025 Accepting new patients
Advantage Health Saint Mary's Medical Group CurrentSince Nov 1, 2023 Accepting new patients
Mercy Health Partners Past Accepting new patients
Valley Radiotherapy Associates Medical Group Inc Past Accepting new patients
Santa Clarita Radiotherapy Medical Group Radiation Oncology Past Accepting new patients
Radiation Oncology Assoc of North Jersey PA Radiation Oncology Past Accepting new patients

Locations

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

250 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 685-5600

1440 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-2008

1440 E Sherman Blvd
Ste 300
Muskegon, MI 49444
Phone (231) 672-2008

5950 Metro Way SW
Wyoming, MI 49519
Phone (616) 252-8100

Interoperability endpoints

  • Direct secure messaging: cwilson1158639@direct.trinity-health.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1548245772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 METRO WAY SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199514",
            "telephone_number": "616-252-8180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1668 S US Highway 421",
            "address_purpose": "LOCATION",
            "city": "Westville",
            "state": "IN",
            "postal_code": "463919523",
            "country_code": "US",
            "telephone_number": "800-860-8100",
            "fax_number": "219-785-3401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHESTER",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IN",
            "license": "01064288A",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MI",
            "license": "4301508350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548245712",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200882630",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.