NPIMap

Organization Active NPI

Wilson Medical Center, Inc.

Doing business as WorkWell Clinic

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Wilson, NC
National Provider Identifier
1578901005
Registry record updated Jun 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
Legal business name
WILSON MEDICAL CENTER, INC.
Doing business as
WorkWell Clinic
Practice address
1705 Tarboro St SW
Wilson, NC 27893-3428
Phone
(252) 399-8040
Fax
(252) 399-8778
NPI assigned
Jun 6, 2013
Last updated
Jun 6, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2013

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

Authorized official

Name
Mr. Richard E Hudson
Title
President and Ceo
Phone
(252) 399-8139

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X NU Primary

Addresses

Primary practice location

1705 Tarboro St SW
Wilson, NC 27893-3428

Mailing address

1705 Tarboro St SW
Wilson, NC 27893-3428
Phone (252) 399-8040

Other identifiers 2

IdentifierTypeStateIssuer
3400126MedicaidNC
3400126AMedicaidNC

Other names 1

  • WorkWell Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Stantonsburg Med of Wil10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370476800000",
    "number": "1578901005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 TARBORO ST SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933428",
            "telephone_number": "252-399-8040",
            "fax_number": "252-399-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 TARBORO ST SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933428",
            "telephone_number": "252-399-8040",
            "fax_number": "252-399-8778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-06",
        "last_updated": "2013-06-06",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "252-399-8139",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3400126",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3400126A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WorkWell Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 6, 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.