Virginia K Wilson, MD

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

35937-020 Issued in WI

Practice address

705 S University Ave Ste 510
Beaver Dam, WI 53916-3081

Phone

(920) 356-9288

Fax

(920) 356-1835

NPI assigned

May 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Dean Health Systems, Inc

  dba SSM Health Dean Medical Group

  • Allergy & Immunology Physician
  • Madison, WI
  • NPI 1053358846

  Internal Medicine

  Medicare reassignment NPD
• Dean Health Systems, Inc.

  dba SSM Health Davis Duehr Dean Eye Care - Portage

  • Durable Medical Equipment & Medical Supplies
  • Portage, WI
  • NPI 1427085679
  NPD

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1558312900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 S UNIVERSITY AVE STE 510",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163081",
            "telephone_number": "920-356-9288",
            "fax_number": "920-356-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S UNIVERSITY AVE STE 510",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163081",
            "telephone_number": "920-356-9288",
            "fax_number": "920-356-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "VIRGINIA",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "35937-020",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WI",
            "license": "35937-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558312900",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vwilson259926@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "vwilson259926@direct-ehr-ssmhc.com",
            "address_1": "705 S University Ave Ste 510",
            "city": "Beaver Dam",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539163081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "705 S University Ave Ste 510",
            "city": "Beaver Dam",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539163081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sean K Wiemann, PHARM D.
• Jay M Wilkins, MD
• Melodie S Willihnganz, MS CLL A
• Molly Willihnganz, MS, LMFT
• Wilson H Luy Tan, MD LTD
• Ruth Ann Wimmer, RN BSN
• Kevin Wippermann
• Michelle Joan Wolff, NP
• Ashley Beth Wolosek-Raatz
• Raymond Michael Wood, PHD

• Rheumatology Physician in Beaver Dam, WI
• Providers in Beaver Dam, WI by specialty
• Rheumatology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.