Brent C Wilson, M.D.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

17280 Issued in OK

Practice address

4300 W Memorial Rd
Oklahoma City, OK 73120-8304

Phone

(405) 752-3715

NPI assigned

May 1, 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

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Partners in Care Hospice, LLC

  • Community Based Hospice Care Agency
  • Auburn, CA
  • NPI 1518476845

  Contracted Managing Employee

  CMS ownership

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.

• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550
  Medicare reassignment NPD
• Mercy Hospital Logan County Inc

  • Critical Access Hospital
  • Guthrie, OK
  • NPI 1306126818
  Medicare reassignment NPD
• Mercy Hospital Logan County, Inc

  • Rural Health Clinic/Center
  • Crescent, OK
  • NPI 1659652071
  NPD
• Mercy Hospital Oklahoma City, Inc

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1184721722
  NPD (past)

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1760440879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 W MEMORIAL RD",
            "address_2": "SUITE 140",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341785",
            "telephone_number": "405-752-3162",
            "fax_number": "405-936-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208304",
            "telephone_number": "405-752-3715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRENT",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OK",
            "license": "17280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100213520B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angel L Wilson, MS, LMFT
• Anthony Robert Wilson
• Ashley Wilson, LCSW
• Brenda June Wilson, APRN CNP
• Brent Wilson, RD/LD
• Danielle Nicole Wilson
• Darla Dawn Wilson
• Darnisha Wilson
• David S Wilson, MD
• Debbie Wilson

• Emergency Medical Services (Emergency Medicine) Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.