Individual provider Active NPI

Carolyn S. Wilson, M.D.

  • Gynecology Physician
  • Charlottesville, VA
National Provider Identifier
1720159056
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
010149676 Issued in VA
Practice address
2955 Ivy Rd Ste 104
Charlottesville, VA 22903-9353
Phone
(434) 243-4720
Fax
(434) 243-4733
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 010149676 VA Primary

Addresses

Primary practice location

2955 Ivy Rd Ste 104
Charlottesville, VA 22903-9353

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007

Other practice location 1

1215 Lee St
Charlottesville, VA 22908-9353
Phone (434) 924-0211

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cwilson112482@direct.healthsystem.virginia.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20110228000259 VA Practitioner - Obstetrics/Gynecology 8729269501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Virginia Commonwealth University, School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1215 Lee St
Charlottesville, VA 22908-0816

2955 Ivy Rd
Charlottesville, VA 22903-9353

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.45 of 100Reported as group
Quality
79.76
Promoting interoperability
100
Improvement activities
40
Cost
75.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010149676VAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Jan 2, 2015 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2955 Ivy Rd
Ste 104
Charlottesville, VA 22903
Phone (434) 243-4720

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

Interoperability endpoints

  • Direct secure messaging: cwilson112482@direct.healthsystem.virginia.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1720159056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 IVY RD STE 104",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229039353",
            "telephone_number": "434-243-4720",
            "fax_number": "434-243-4733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229089353",
            "country_code": "US",
            "telephone_number": "434-924-0211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CAROLYN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "VA",
            "license": "010149676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwilson112482@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2955 Ivy Rd Ste 104",
            "city": "Charlottesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229039353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.