Individual provider Active NPI

Wilson Greene McWilliams, M.D.

  • Ophthalmology Physician
  • Columbia, SC
National Provider Identifier
1912960212
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
13786 Issued in SC
Practice address
9 Richland Medical Park Dr Ste 340
Columbia, SC 29203-6870
Phone
(803) 434-2020
Fax
(803) 434-1581
NPI assigned
Apr 8, 2006
Last updated
Mar 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 2009-00114 NC
Ophthalmology Physician 207W00000X 13786 SC Primary

Addresses

Primary practice location

9 Richland Medical Park Dr Ste 340
Columbia, SC 29203-6870

Mailing address

PO Box 402145
Atlanta, GA 30384-2145
Phone (803) 296-7320

Other identifiers 1

IdentifierTypeStateIssuer
TL2725MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20090826000078 NC Practitioner - Ophthalmology 7618022740

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Eye Associates Inc Ophthalmology Current Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients
Pediatric Ophthalmology Associates, P.a. Ophthalmology Past Accepting new patients

Locations

1991 Fordham Dr
Ste 301
Fayetteville, NC 28304
Phone (910) 484-7744

2170 Midland Rd
Southern Pnes, NC 28387
Phone (910) 295-1221

705 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 537-6962

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1912960212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 402145",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303842145",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 RICHLAND MEDICAL PARK DR STE 340",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036870",
            "telephone_number": "803-434-2020",
            "fax_number": "803-434-1581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCWILLIAMS",
        "first_name": "WILSON",
        "middle_name": "GREENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "2009-00114",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "13786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TL2725",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.