Gregory Charles Wilson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

100505 Issued in NC

Practice address

2280 Hemby LN
Greenville, NC 27834-3773

Phone

(252) 744-9400

Fax

(252) 744-9401

NPI assigned

Oct 31, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1902085491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751069",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 HEMBY LN",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343773",
            "telephone_number": "252-744-9400",
            "fax_number": "252-744-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "GREGORY",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-31",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "100505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902085491",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "19FUD",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kate Fireovid Willson, RD
• Laurel Wilsen, MS, CCC-SLP
• Allena Claire Wilson, MD
• Carol Lashae' Wilson, ANP
• Courtney Elizabeth Wilson, PA
• Jimmy-John Clifford Wilson, CRNA
• Karen Wilson, FNP
• Margaret B. Wilson, DDS
• Mary Kristin Wilson, SLP-CCC
• Matthew Wilson

• Physician Assistant in Greenville, NC
• Providers in Greenville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.