Kelsey Derrick Wilson, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

85751 Issued in SC

Practice address

3B Cleveland CT
Greenville, SC 29607-2414

Phone

(864) 272-3300

Fax

(864) 272-3311

NPI assigned

Mar 26, 2017

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 names 1

• Kelsey D Wilson Former name

Medicare fee-for-service enrollment

Enrolled in SC

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

Dermatology

Education

Medical University of South Carolina College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rogers Dermatology, P.a.Group PAC ID 6305915869, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.64 of 100Reported as individual

Quality

93.28

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Rogers Dermatology, P.a.

  • Specialist
  • Greenville, SC
  • NPI 1598923807
  Medicare reassignment Care Compare group NPD
• Rogers Dermatology, PA

  • Procedural Dermatology Physician
  • Greenville, SC
  • NPI 1912950775
  NPD

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

{
    "created_epoch": "1490486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1821529348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 MILLS AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054019",
            "telephone_number": "864-272-3300",
            "fax_number": "864-272-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3B CLEVELAND CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072414",
            "telephone_number": "864-272-3300",
            "fax_number": "864-272-3311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "213 Mills Ave",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054019",
            "country_code": "US",
            "telephone_number": "864-272-3300",
            "fax_number": "864-272-3311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KELSEY",
        "middle_name": "DERRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-26",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "85751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "WILSON",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James C Wilson, DMD
• Jamie Richelle Wilson, MS, ADC-P
• Jeremy R Wilson, DC
• John David Wilson, MD
• Joshlyn Jamecia Wilson
• Marc David Wilson, DC
• Marcus A. Wilson, D.M.D.
• Marcus Edward Wilson, CRNA
• Matthew Wilson, M.D.
• Michelle Margarita Wilson, M.D.

• Dermatology Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Dermatology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.