William Carl Wilson, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS5519 Issued in FL

Practice address

4400 Bayou Blvd
Suite 49a
Pensacola, FL 32503-2673

Phone

(850) 476-0003

Fax

(850) 476-4724

NPI assigned

Jun 30, 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241654400000",
    "number": "1679502108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 BAYOU BLVD",
            "address_2": "SUITE 49A",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032673",
            "telephone_number": "850-476-0003",
            "fax_number": "850-476-4724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 BAYOU BLVD",
            "address_2": "SUITE 49A",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032673",
            "telephone_number": "850-476-0003",
            "fax_number": "850-476-4724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "WILLIAM",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2009-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS5519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "061538200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE TAX ID",
            "identifier": "592966180",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert K Wilson Jr., MD
• Sara Marie Wilson, CPNP-AC
• Savannah Jade Wilson, PA-C
• Teresa K Wilson, CRNA
• Wanda Wilson
• Rhonda D Wilstrup, CNM, ARNP
• Windermere Memory Care Inc.
• Nancy S Windham, M.S.
• Olivia G Windham, DC
• Pamela Kay Windham, MSC/CCC/SLP

• Family Medicine Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.