Renee Wilson, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

229528 Issued in MA

Practice address

235 N Pearl St
Brockton, MA 02301-1794

Phone

(508) 427-2090

NPI assigned

Sep 19, 2005

Sex

Female

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

Enrolled in MA

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

Specialty

Emergency Medicine

Education

Columbia University College of Physicians and Surgeons, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carecentral Urgent Care Medical Group PCGroup PAC ID 5496907099, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Carecentral Urgent Care Medical Group PC

  • Urgent Care Clinic/Center
  • Stoughton, MA
  • NPI 1922385319
  Medicare reassignment Care Compare group NPD Authorized official
• Carecentral Urgent Care Medical Group PC

  • Urgent Care Clinic/Center
  • Halifax, MA
  • NPI 1053119677
  NPD Authorized official
• Carecentral Urgent Care Medical Group PC

  • Urgent Care Clinic/Center
  • Bridgewater, MA
  • NPI 1447602412
  NPD (past) Authorized official
• Carecentral Urgent Care Medical Group PC

  • Urgent Care Clinic/Center
  • Stoughton, MA
  • NPI 1679966022
  NPD (past) Authorized official

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493337600000",
    "number": "1740275403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 N PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011794",
            "telephone_number": "508-427-3034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 N PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011794",
            "telephone_number": "508-427-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "RENEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-19",
        "last_updated": "2017-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "229528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110075069A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sean Willoughby, MSPT, PT
• Courtney Wills
• Eileen Nancy Wilmarth-Guerette, RN
• Kirk George Wilmot
• Latisha Wilson
• Robert Wilson
• Roxanne Wilson
• Vicki Wilson, M.S.
• Jamie Carol Wine, LMHC
• Wingate Transportation LLC

• Emergency Medicine Physician in Brockton, MA
• Providers in Brockton, MA by specialty
• Emergency Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.