NPIMap

Individual provider Active NPI

Shawn Anthony Wilson, D.O.

  • Orthopaedic Surgery Physician
  • Suffolk, VA
National Provider Identifier
1699068445
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
0102205257 Issued in VA
Practice address
5838 Harbour View Blvd BLDG Ste 100
Suffolk, VA 23435-2663
Phone
(757) 673-5680
Fax
(757) 483-3075
NPI assigned
May 25, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 0102205257 VA Primary

Addresses

Primary practice location

5838 Harbour View Blvd BLDG Ste 100
Suffolk, VA 23435-2663

Mailing address

5838 Harbour View Blvd BLDG Ste 100
Suffolk, VA 23435-2663
Phone (757) 673-5680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180926002748 VA Practitioner - Orthopedic Surgery 0648590612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Medical Group Hampton Roads Specialty Care LLCGroup PAC ID 3173955671, 197 clinicians

Practice addresses (Care Compare)

1040 University Blvd
Portsmouth, VA 23703-2650

150 Kingsley LN
Norfolk, VA 23505-4602
Phone (757) 398-2673

3636 High St
Portsmouth, VA 23707-3236
Phone (757) 398-2222

5818 Harbour View Blvd
Suffolk, VA 23435-3315

930 W 21St St
Norfolk, VA 23517-1516

Hospital & facility affiliations

  • Bon Secours Maryview Medical Center Hospital, Portsmouth, VA, CCN 490017
  • Bon Secours Harbour View Medical Center Hospital, Suffolk, VA, CCN 490148
  • Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044
  • Bon Secours Southampton Memorial Hospital Hospital, Franklin, VA, CCN 490092

Merit-based Incentive Payment System (MIPS)

Final score
87.65 of 100Reported as individual
Quality
77.54
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC Orthopaedic Surgery CurrentSince Jan 1, 2020 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC Orthopaedic Surgery CurrentSince Jan 1, 2020 Accepting new patients

Locations

930 W 21st St
Ste 100
Norfolk, VA 23517
Phone (757) 622-8358

150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944

7007 Harbour View Blvd
Ste 108
Suffolk, VA 23435
Phone (757) 215-2784

2012 Meade Pkwy
Suffolk, VA 23434
Phone (757) 539-1477

1009 Centerbrooke Ln
Ste 208
Suffolk, VA 23434

5838 Harbour View Blvd
Ste 100
Suffolk, VA 23435
Phone (757) 483-0407

Interoperability endpoints

  • Direct secure messaging: swilson1156945@direct.bsmhealth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1699068445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5838 HARBOUR VIEW BLVD BLDG STE 100",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234352663",
            "telephone_number": "757-673-5680",
            "fax_number": "757-483-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5838 HARBOUR VIEW BLVD BLDG STE 100",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234352663",
            "telephone_number": "757-673-5680",
            "fax_number": "757-483-3075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHAWN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-25",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0102205257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.