Vincent Paul Wilson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2012-01585 Issued in NC

Practice address

201 N Breazeale Ave
Mount Olive, NC 28365-1603

Phone

(919) 658-4954

Fax

(919) 658-5754

NPI assigned

May 19, 2006

Sex

Male

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

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Family Practice

Education

Brody School of Medicine at East Carolina University, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mt Olive Family Medicine Center IncGroup PAC ID 3870547227, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Goldsboro, NC, CCN 347331
• 3HC Home health agency, Goldsboro, NC, CCN 347104
• Unc Health Care Wayne Hospital, Goldsboro, NC, CCN 340010

Merit-based Incentive Payment System (MIPS)

Final score

82.75 of 100Reported as individual

Quality

67.76

Improvement activities

40

Cost

85.49

Procedures performed for Medicare patients

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.

• Mt Olive Family Medicine Center Inc

  • Family Medicine Physician
  • Mount Olive, NC
  • NPI 1467481762
  Medicare reassignment Care Compare group NPD
• Vincent Paul Wilson MD,PA

  • Family Medicine Physician
  • Maitland, FL
  • NPI 1467638924
  NPD (past) Authorized official
• Mt. Olive Family Medicine Center

  • Non-Pharmacy Dispensing Site
  • Mount Olive, NC
  • NPI 1639491038
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Home Health and Hospice Care, Inc.

  • Community Based Hospice Care Agency
  • Goldsboro, NC
  • NPI 1558396622

  Home health agency

  Care Compare affiliation
• Home Health and Hospice Care, Inc.

  • Home Health Agency
  • Goldsboro, NC
  • NPI 1750337366
  Care Compare affiliation
• Tar Heel Health Care Services, LLC

  • Home Health Agency
  • Goldsboro, NC
  • NPI 1558391391
  Care Compare affiliation
• Wayne Memorial Hospital Inc

  • General Acute Care Hospital
  • Goldsboro, NC
  • NPI 1750353462
  Care Compare affiliation

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1609820463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N BREAZEALE AVE",
            "city": "MOUNT OLIVE",
            "state": "NC",
            "postal_code": "283651603",
            "telephone_number": "919-658-4954",
            "fax_number": "919-658-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N BREAZEALE AVE",
            "city": "MOUNT OLIVE",
            "state": "NC",
            "postal_code": "283651603",
            "telephone_number": "919-658-4954",
            "fax_number": "919-658-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "VINCENT",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "70073",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2012-01585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "1609820463",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cody Miles Wendorf
• Marlene Blizzard Whaley, RN, MSN, FNP-C
• White Oak Homes II, Inc.
• Elizabeth Brooke Wice, LMBT, MMP
• Shana Denise Williams
• Xeon Enterprises Inc
• Allison Young, MS, ATC, LAT
• Linda Marie Young

• Family Medicine Physician in Mount Olive, NC
• Providers in Mount Olive, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; 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.