Individual provider Active NPI

Mark E Wilson, M.D.

  • Internal Medicine Physician
  • Birmingham, AL
National Provider Identifier
1760410997
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
15807 Issued in AL
Practice address
1515 6TH Ave S
Birmingham, AL 35233-1601
Phone
(205) 279-2860
Fax
(205) 252-0197
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 15807 AL Primary

Addresses

Primary practice location

1515 6TH Ave S
Birmingham, AL 35233-1601

Mailing address

PO Box 2648
Birmingham, AL 35202-2648
Phone (205) 558-2158

Other identifiers 1

IdentifierTypeStateIssuer
000089050MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20050802001093 AL Practitioner - Internal Medicine 1052349859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Centers LLCGroup PAC ID 3476457011, 184 clinicians

Practice addresses (Care Compare)

817 Princeton Ave SW
Birmingham, AL 35211-1333
Phone (205) 783-3505

Hospital & facility affiliations

  • Princeton Baptist Medical Center Hospital, Birmingham, AL, CCN 010103

Merit-based Incentive Payment System (MIPS)

Final score
85.07 of 100Reported as group
Quality
80.62
Promoting interoperability
100
Improvement activities
40
Cost
69.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15807ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Centers, LLC CurrentSince Jun 11, 2024 Accepting new patients
Baptist Health Centers LLC CurrentSince Jun 11, 2024 Accepting new patients
BBH PBMC, LLC Past Accepting new patients

Locations

1130 22nd St S
Ste 1000
Birmingham, AL 35205
Phone (205) 518-8849

817 Princeton Ave SW
Ste 210
Birmingham, AL 35211
Phone (205) 226-5911

Interoperability endpoints

  • Direct secure messaging: mwilson42495@baptisthealthaldirect.org

Organizations & group practices 3

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 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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1760410997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2648",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352022648",
            "telephone_number": "205-558-2158",
            "fax_number": "205-930-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331601",
            "telephone_number": "205-279-2860",
            "fax_number": "205-252-0197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARK",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "15807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000089050",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.