Brian Andrew Wilson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY8981 Issued in FL

Practice address

16203 Hampton Trace CT
Tampa, FL 33647-2745

Phone

(727) 239-5684

NPI assigned

Jun 15, 2006

Last updated

Sep 12, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Tampa Palms Psychology, LLC

  • Adult Mental Health Clinic/Center
  • Tampa, FL
  • NPI 1679242648
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631404800000",
    "number": "1558305359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17401 COMMERCE PARK BLVD STE 103-0319",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473501",
            "telephone_number": "727-239-5684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16203 HAMPTON TRACE CT",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472745",
            "telephone_number": "727-239-5684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRIAN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2021-09-12",
        "certification_date": "2021-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Asmita Wilson Morris, MD
• Jessica Jill Wilson-Chan, D.O.
• Alexis Caitlyn Wilson
• Anna Wilson
• Axel W Wilson, MD
• Catharine Ellen Wilson
• Celeste Wilson
• Chelsie Wilson
• Cheryl Linn Wilson, ARNP
• Christine Wilson, PHD, ARNP

• Clinical Psychologist in Tampa, FL
• Providers in Tampa, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2021; 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.

Verify at the official NPI Registry.