Individual provider Active NPI

Raymond E Wilson, MD

  • Anesthesiology Physician
  • Memphis, TN
National Provider Identifier
1902883713
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
16103 Issued in TN
Practice address
1265 Union Ave
Memphis, TN 38104-3415
Phone
(901) 725-5846
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 16103 TN Primary

Addresses

Primary practice location

1265 Union Ave
Memphis, TN 38104-3415

Mailing address

6060 Primacy Pkwy
Suite 241
Memphis, TN 38119-5745
Phone (901) 725-5846

Other identifiers 1

IdentifierTypeStateIssuer
3017346MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 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

Enrollment IDStateProvider typePAC IDDetails
I20100805001023 TN Practitioner - Anesthesiology 8123151438 Reassigns benefits to 2 organizations
I20151106000152 MS Practitioner - Anesthesiology 8123151438 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Tennessee, HSC, College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willow Anesthesia Services LLCGroup PAC ID 9234279183, 52 clinicians
Medical Anesthesia Group, PAGroup PAC ID 9436047685, 42 clinicians

Practice addresses (Care Compare)

2100 Exeter Rd
Suite 200
Germantown, TN 38138-3966
Phone (901) 699-4436

4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone (662) 932-9000

499 Azalea Dr
Oxford, MS 38655-7901
Phone (662) 234-7979

Merit-based Incentive Payment System (MIPS)

Final score
85.75 of 100Reported as group
Quality
83.24
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Anesthesia Group, PA Anesthesiology CurrentSince Jul 1, 1987 Accepting new patients
Resource Anesthesiology Associates of TN PC Anesthesiology CurrentSince Jul 29, 2024 Accepting new patients

Locations

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

450 Mamaroneck Ave
Ste 201
Harrison, NY 10528
Phone (877) 476-6642

1363 S Germantown Rd
Memphis, TN 38138
Phone (901) 516-6000

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

6060 E Primacy Pkwy
Ste 241
Memphis, TN 38119
Phone (901) 725-5846

1755 Kirby Pkwy
Ste 330
Memphis, TN 38120
Phone (901) 725-5846

1265 Union Ave
Ste 201
Memphis, TN 38104
Phone (901) 516-7000

Interoperability endpoints

  • Direct secure messaging: rwilson32552@mlh.direct-ci.com

Organizations & group practices 3

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1902883713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6060 PRIMACY PKWY",
            "address_2": "SUITE 241",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195745",
            "telephone_number": "901-725-5846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043415",
            "telephone_number": "901-725-5846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "RAYMOND",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "16103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3017346",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.