William L Wilson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

238644 Issued in MA

Practice address

85 Herrick St
Lahey at Beverly Hospital
Beverly, MA 01915-1790

Phone

(978) 922-3000

Fax

(978) 921-7048

NPI assigned

Aug 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MA

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

Interoperability endpoints

• Direct secure messaging: wwilson19752@direct.southcoast.org

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.

• Ipc Hospitalists of New England, P.C.

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1659555266

  Family Medicine

  Medicare reassignment NPD
• Winchester Lahey Inpatient Specialists PLLC

  • Internal Medicine Physician
  • Winchester, MA
  • NPI 1144770629
  Medicare reassignment NPD
• Chisholm Medical Clinic

  • Family Medicine Physician
  • Chisholm, MN
  • NPI 1871507632
  NPD (past) Authorized official
• Ipc Hospitalists of New England PC

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1801330287

  Family Medicine

  NPD

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1639284300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 HERRICK ST",
            "address_2": "LAHEY AT BEVERLY HOSPITAL",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151790",
            "telephone_number": "978-922-3000",
            "fax_number": "978-921-7048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HERRICK ST",
            "address_2": "LAHEY AT BEVERLY HOSPITAL",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151790",
            "telephone_number": "978-922-3000",
            "fax_number": "978-921-7048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "WILLIAM",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "22648",
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "MA",
            "license": "238644",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "238644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J47582",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "55A04WI",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110086079A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "755590300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick Willwerth, M.ED., LADC-I
• Adia Niara Wilson-Dawson, WHNP-BC
• Bonnie S Wilson, PT
• Jeanne Marie Wilson, ATR BC
• Kenia Wilson
• Kristy Winata, DMD
• Winchester Pain Associates LLC
• Emily Suzanne Wing, LICSW
• Janet Winocour, LICSW
• Michael J Winocour, LICSW

• Family Medicine Physician in Beverly, MA
• Providers in Beverly, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.