Individual provider Active NPI

William Allen Wilson, MD

  • Internal Medicine Physician
  • Burke, VA
National Provider Identifier
1902939267
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
VA0101037977 Issued in VA
Practice address
9261 Old Keene Mill Rd
Burke, VA 22015
Phone
(703) 451-9095
Fax
(703) 455-2239
NPI assigned
Mar 14, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X VA0101037977 VA Primary
Internal Medicine Physician 207R00000X 43184 FL
Internal Medicine Physician 207R00000X 32011 IN

Addresses

Primary practice location

9261 Old Keene Mill Rd
Burke, VA 22015

Mailing address

9261 Old Keene Mill Rd
Burke, VA 22015
Phone (703) 451-9095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20120201000901 DC Practitioner - Internal Medicine 4981861036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Indiana University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9261 Old Keene Mill Rd
Burke, VA 22015-4202
Phone (703) 451-9095

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43184FLMDInternal Medicine Physician
32011INMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William a Wilson MD PC Internal Medicine CurrentSince Dec 2, 1998 Accepting new patients

Locations

9261 Old Keene Mill Rd
Burke, VA 22015
Phone (703) 451-9095

Interoperability endpoints

  • Direct secure messaging: william.wilson.1@14028.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902939267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9261 OLD KEENE MILL RD",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "22015",
            "telephone_number": "703-451-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9261 OLD KEENE MILL RD",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "22015",
            "telephone_number": "703-451-9095",
            "fax_number": "703-455-2239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "WILLIAM",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "VA0101037977",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "43184",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "32011",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burke, VA

Sources for this page

Verify at the official NPI Registry.