Active NPI
Wilson Medical Center, Inc.
- Family Medicine Physician
- Stantonsburg, NC
National Provider Identifier
1902932478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- WILSON MEDICAL CENTER, INC.
- Practice address
- 312 South Main Street
Stantonsburg, NC 27883-0400 - Phone
- (252) 238-2757
- Fax
- (252) 399-8829
- NPI assigned
- Feb 26, 2007
- Organization subpart
- Yes
- Parent organization
- WILSON MEDICAL CENTER
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Richard E. Hudson
- Title
- President and Chief Executive Offic
- Phone
- (252) 399-8193
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
312 South Main Street
Stantonsburg, NC 27883-0400
Mailing address
312 South Main Street
P.O. Box 400
Stantonsburg, NC 27883-0400
Phone (252) 238-2757
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0232U | Other | NC | NC BLUE CROSS PROVIDER NO |
| 890232U | Medicaid | NC |
Other names 1
- Stantonsburg Medical Center
National Provider Directory
National Provider Directory- Part of
- Wilson Medical Center Inc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1189123200000",
"number": "1902932478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 SOUTH MAIN STREET",
"address_2": "P.O. BOX 400",
"city": "STANTONSBURG",
"state": "NC",
"postal_code": "278830400",
"telephone_number": "252-238-2757",
"fax_number": "252-399-8829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 SOUTH MAIN STREET",
"city": "STANTONSBURG",
"state": "NC",
"postal_code": "278830400",
"telephone_number": "252-238-2757",
"fax_number": "252-399-8829"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILSON MEDICAL CENTER, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WILSON MEDICAL CENTER",
"enumeration_date": "2007-02-26",
"last_updated": "2007-09-07",
"status": "A",
"authorized_official_last_name": "HUDSON",
"authorized_official_first_name": "RICHARD",
"authorized_official_middle_name": "E.",
"authorized_official_title_or_position": "PRESIDENT AND CHIEF EXECUTIVE OFFIC",
"authorized_official_telephone_number": "252-399-8193"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC BLUE CROSS PROVIDER NO",
"identifier": "0232U",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890232U",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Stantonsburg Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Stantonsburg, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.