Shirley Diann Wilson, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

034742 Issued in GA

Practice address

2500 Starling St
Suite 606
Brunswick, GA 31520-4219

Phone

(912) 466-5636

Fax

(912) 466-5639

NPI assigned

Jun 23, 2006

Last updated

Aug 29, 2014By the provider in NPPES

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 GA, NC2 enrollments

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 2

Specialty

Obstetrics/Gynecology

Education

University of Arkansas College of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cooperative Healthcare Services IncGroup PAC ID 9830093640, 235 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Georgia Health System- Brunswick Campus Hospital, Brunswick, GA, CCN 110025

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: swilson@secure.sghsmessaging.org
• Direct secure messaging: swilson1114200@direct.unc.nchie.net

All facility ownership & control disclosures 4

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

Owned or controlled facilities with NPI records 4

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

• Southeast Georgia Health System, Inc.

  dba Southeast Georgia Health System - Camden Campus

  • General Acute Care Hospital
  • Saint Marys, GA
  • NPI 1194744326

  Corporate Director

  CMS ownership
• Southeast Georgia Health System, Inc.

  dba Southeast Georgia Health System - Brunswick Campus

  • General Acute Care Hospital
  • Brunswick, GA
  • NPI 1598784720

  Corporate Director

  CMS ownership
• Southeast Georgia Health System, Inc.

  • Skilled Nursing Facility
  • Brunswick, GA
  • NPI 1619135464

  Corporate Director

  CMS ownership
• Southeast Georgia Health System, Inc.

  dba Senior Care Center - St. Marys

  • Skilled Nursing Facility
  • Saint Marys, GA
  • NPI 1720169147

  Corporate Director

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cooperative Healthcare Services Inc

  dba Southeast Georgia Physician Associates

  • Clinic/Center
  • Brunswick, GA
  • NPI 1417979402

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Henderson County Hospital Corporation

  dba Pardee Medical Associates

  • Multi-Specialty Clinic/Center
  • Hendersonville, NC
  • NPI 1447444559
  Medicare reassignment NPD
• Unc Physicians Network LLC

  dba UNC Family Medicine at Pittsboro

  • Family Medicine Physician
  • Pittsboro, NC
  • NPI 1750704367
  Medicare reassignment NPD
• Henderson County Hospital Corporation

  dba Pardee Rx-Fleming

  • Community/Retail Pharmacy
  • Hendersonville, NC
  • NPI 1013694165
  NPD
• Unc Physicians Network LLC

  • General Practice Physician
  • Morrisville, NC
  • NPI 1558786830

  Obstetrics & Gynecology

  NPD
• Mario L Forcina Jr MD PC

  • Ophthalmology Physician
  • Brunswick, GA
  • NPI 1649516196
  NPD (past)
• Southeast Georgia Health System, Inc.

  dba Southeast Georgia Health System - Brunswick Campus

  • General Acute Care Hospital
  • Brunswick, GA
  • NPI 1598784720
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southeast Georgia Health System, Inc.

  dba Southeast Georgia Health System - Brunswick Campus

  • General Acute Care Hospital
  • Brunswick, GA
  • NPI 1598784720
  Care Compare affiliation

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409270400000",
    "number": "1790711851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 STARLING ST",
            "address_2": "SUITE 606",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204219",
            "telephone_number": "912-466-5636",
            "fax_number": "912-466-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 STARLING ST",
            "address_2": "SUITE 606",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204219",
            "telephone_number": "912-466-5636",
            "fax_number": "912-466-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHIRLEY",
        "middle_name": "DIANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2014-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "034742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00516139D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Tillman Williams, MD
• Melanie Williamson
• Tom Vann Willis Jr., M.D.
• Heather M Wilson, DMD
• Michelle Renee Wilson, DPT
• Stephanie Roselind Wilson, LPC
• Wings of Feathers Medical Clinic
• Klaus Joseph Wittemann
• Wmi Marketing Group,Inc
• Women's Health Group SE Ga

• Obstetrics & Gynecology Physician in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.
• 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.