Active NPI
Brandon Wilson
- Student in an Organized Health Care Education/Training Program
- Lebanon, NH
National Provider Identifier
1780334862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1 Medical Center Dr
Dept of Psychiatry
Lebanon, NH 03756-1000 - Phone
- (603) 650-5000
- NPI assigned
- Mar 24, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 39353 | NH | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1 Medical Center Dr
Dept of Psychiatry
Lebanon, NH 03756-1000
Mailing address
1 Medical Center Dr
Dept of Psychiatry
Lebanon, NH 03756-1000
Phone (603) 650-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of New Hampshire | Current | Accepting new patients | |
| State of New Hampshire | Current | Accepting new patients |
Locations
36 Clinton St
Concord, NH 03301
Phone (603) 271-5075
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781568000000",
"number": "1780334862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"address_2": "DEPT OF PSYCHIATRY",
"city": "LEBANON",
"state": "NH",
"postal_code": "037561000",
"telephone_number": "603-650-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"address_2": "DEPT OF PSYCHIATRY",
"city": "LEBANON",
"state": "NH",
"postal_code": "037561000",
"telephone_number": "603-650-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "BRANDON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-24",
"last_updated": "2026-06-16",
"certification_date": "2026-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NH",
"license": "39353",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; 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.