Reginald Calvert Wilson Jr.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P013752 Issued in NC

Practice address

1502 W NC Highway 54 Ste 403
Durham, NC 27707-5599

Phone

(919) 418-1718

Fax

(919) 794-5715

NPI assigned

Jan 31, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tonya D Armstrong PLLC

  • Clinical Child & Adolescent Psychologist
  • Raleigh, NC
  • NPI 1235264730
  Medicare reassignment NPD
• Baart Community Healthcare

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Durham, NC
  • NPI 1376075556
  NPD (past)
• Counseling Professionals PLLC

  • Multi-Specialty Clinic/Center
  • Raleigh, NC
  • NPI 1740634773

  Clinical

  NPD (past)

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

{
    "created_epoch": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1720619414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 CALLOWAY DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276104008",
            "telephone_number": "919-412-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 W NC HIGHWAY 54 STE 403",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075599",
            "telephone_number": "919-418-1718",
            "fax_number": "919-794-5715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "REGINALD",
        "middle_name": "CALVERT",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-31",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P013752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Marie Wilson, LMFT
• Lorena Rocha Wilson, M.D.
• Megan Wilson, RN
• Megan Wilson
• Michael Jeremy Wilson, DDS PA
• Robert J. Wilson III, M.D.
• Robyn Hillary Hoffman Wilson, DPT, NCS
• Sarah Cathryn Wilson, PHD
• Sarah Mosher Wilson, PHD
• Vanisha Rochelle Wilson, M.D.

• Clinical Social Worker in Durham, NC
• Providers in Durham, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.