Harold T Wilson, MD

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

9701199 Issued in NC

Practice address

16063 Vanowen St
Van Nuys, CA 91406-4810

Phone

(818) 785-9989

Fax

(818) 785-3330

NPI assigned

Aug 26, 2005

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 3

Medicare fee-for-service enrollment

Enrolled in CA

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

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: harold.wilson.p1@direct.arroyovista.nextgenshare.com

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.

• Arroyo Vista Family Health Foundation

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1447353701
  Medicare reassignment NPD
• Arroyo Vista Family Health Foundation

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1891837621
  NPD
• Roy Medical Group, Inc.

  • General Practice Physician
  • Canoga Park, CA
  • NPI 1801921952
  NPD (past)

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1619960457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16063 VANOWEN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914064810",
            "telephone_number": "818-785-9989",
            "fax_number": "818-785-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16063 VANOWEN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914064810",
            "telephone_number": "818-785-9989",
            "fax_number": "818-785-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "HAROLD",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A 38694",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NC",
            "license": "9701199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1619960457",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5910044",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619960457",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Willow Springs Hospice Care
• Alison Nellie Wilson
• Christine J. Wilson, RN, HEC-C
• Delanie Wilson
• Elissa Ann Wilson, LMFT, LAADC
• Marquis Lamont Wilson
• Matthew David Wilson, RADT
• Raker Alan Wilson, AMFT
• Rayne Ashley Wilson
• Ronald Dean Wilson

• Pediatric Emergency Medicine (Pediatrics) Physician in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; 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.