Samuel Mayhew Wilson, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

33377 Issued in SC

Practice address

1073 Medical Ridge Rd
Clinton, SC 29325-4542

Phone

(864) 833-3557

Fax

(864) 833-7724

NPI assigned

Mar 8, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in SC

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

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.

• Greenville Health System

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1568532513
  Medicare reassignment NPD
• Greenville Health System

  • General Acute Care Hospital
  • Clinton, SC
  • NPI 1043650567
  NPD
• Greenville Health System

  • General Acute Care Hospital
  • Simpsonville, SC
  • NPI 1679992838
  NPD

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1609844653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1073 MEDICAL RIDGE RD",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293254542",
            "telephone_number": "864-833-3557",
            "fax_number": "864-833-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SAMUEL",
        "middle_name": "MAYHEW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "33377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000663301",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020042401",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "333777",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan V Williams, D.C.
• Julie Holcombe Wilmoth, COTA
• Gerald Wayne Wilson, RPH
• Mark R Wilson, M.D.
• Rosalyn Shantay Wilson
• Kimberly J Winters, MSN
• Worley Chiropractic Clinic PA
• Donald B Worley, R.T., B.A., D.C.
• Sarah Revis Wyatt, DPT
• Sheree Wyatt, LMSW

• Surgery Physician in Clinton, SC
• Providers in Clinton, SC by specialty
• Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.