Individual provider Active NPI

Lynnford S Wilson, M.D.

  • Orthopaedic Surgery Physician
  • Sterling, VA
National Provider Identifier
1588645865
Registry record updated Dec 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
0101045190 Issued in VA
Practice address
21475 Ridgetop Cir
Suite 150
Sterling, VA 20166-6580
Phone
(703) 444-5000
Fax
(703) 444-4999
NPI assigned
Nov 14, 2005
Last updated
Dec 2, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 0101045190 VA Primary

Addresses

Primary practice location

21475 Ridgetop Cir
Suite 150
Sterling, VA 20166-6580

Mailing address

21475 Ridgetop Cir
Ste 150
Sterling, VA 20166-6580
Phone (703) 444-5000

Other identifiers 2

IdentifierTypeStateIssuer
10011914MedicaidVA
39620003OtherDCCAREFIRST OF DC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040309000782 VA Practitioner - Orthopedic Surgery 7911895115 Reassigns benefits to 1 organization
I20041103000471 DC Practitioner - Orthopedic Surgery 7911895115 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101045190VAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Minimally Invasive Spinecare, Inc PastSince Apr 18, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Mishawaka Orthopedics and Sports Medicine P C Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.70617

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259712000000",
    "number": "1588645865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21475 RIDGETOP CIR",
            "address_2": "STE 150",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201666580",
            "telephone_number": "703-444-5000",
            "fax_number": "703-444-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21475 RIDGETOP CIR",
            "address_2": "SUITE 150",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201666580",
            "telephone_number": "703-444-5000",
            "fax_number": "703-444-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LYNNFORD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2009-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0101045190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10011914",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST OF DC",
            "identifier": "39620003",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

Verify at the official NPI Registry.