Connor Keith Wilson, MD, MPH

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

1022809 Issued in MA

Practice address

593 Eddy St
Providence, RI 02903-4923

Phone

(401) 444-6489

NPI assigned

May 14, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Emergency Medicine

Education

University of Arkansas College of Medicine, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Lifespan Physician Group of Massachusetts IncGroup PAC ID 3870020399, 458 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Anne'S Hospital Hospital, Fall River, MA, CCN 220020

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.

• Lifespan Physician Group of Massachusetts Inc

  • Family Medicine Physician
  • Taunton, MA
  • NPI 1235957713

  Emergency Medicine

  Medicare reassignment Care Compare group NPD

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

• Lifespan of Massachusetts - Fall River Inc

  • General Acute Care Hospital
  • Fall River, MA
  • NPI 1972330165
  Care Compare affiliation

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1891369906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-6489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CONNOR",
        "middle_name": "KEITH",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-14",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "1022809",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "RI",
            "license": "LP05312",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steve Willis, PHARMD
• Ian Willoughby, PHARMD
• Sandra Wilson-Eisenberg, DO
• Carol R. Wilson, LICSW
• Christina Elizabeth Wilson, DPT
• Corinna Wilson, LMT
• Ira B. Wilson, MD
• Jadine Sandra Wilson, M.ED, BCBA, LBA
• Maurina Wilson, LCDP, LADC, CADC
• Nichole Wilson, NP

• Emergency Medicine Physician in Providence, RI
• Providers in Providence, RI by specialty
• Emergency Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.