Charles V. Wilson Jr., MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

AW 1670757 Issued in FL

Practice address

3525A US Highway 17
Fleming Island, FL 32003-7122

Phone

(904) 215-3880

Fax

(904) 215-3883

NPI assigned

Jun 26, 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 1

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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257724800000",
    "number": "1699702910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525A US HIGHWAY 17",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320037122",
            "telephone_number": "904-215-3880",
            "fax_number": "904-215-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525A US HIGHWAY 17",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320037122",
            "telephone_number": "904-215-3880",
            "fax_number": "904-215-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHARLES",
        "middle_name": "V.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2009-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "AW 1670757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065705100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Willetts, CNM
• Sharlene Y Williams-Velez, PT, DPT
• Michelle Denise Williams, P.A.
• Precious I Williams
• Saphina Williams, ARNP
• Savannah Wilson
• Tatiana Marie Wolfert
• Kristin Wollenzin
• Women'S Care Florida LLC
• Women'S Care Florida LLC

• Specialist in Fleming Island, FL
• Providers in Fleming Island, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.