Individual provider Active NPI

Stephen Lawrence Wilson, MD

  • Surgery Physician
  • Huntington, WV
National Provider Identifier
1932172749
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
15997 Issued in WV
Practice address
1600 Medical Center Dr
Suite2500
Huntington, WV 25701-3656
Phone
(304) 691-1200
Fax
(304) 691-1287
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 15997 WV Primary

Addresses

Primary practice location

1600 Medical Center Dr
Suite2500
Huntington, WV 25701-3656

Mailing address

1600 Medical Center Dr
Suite2500
Huntington, WV 25701-3656
Phone (304) 691-1200

Other identifiers 1

IdentifierTypeStateIssuer
0126588000MedicaidWV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stephen.wilson@marshall.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20060130000057 WV Practitioner - General Surgery 5193739175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Georgia School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1600 Medical Ctr Dr
Suite 2500
Huntington, WV 25701-3657
Phone (304) 691-1200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15997WVMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cabell Huntington Hospital Inc Past Accepting new patients
Holzer Clinic, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: stephen.wilson@marshall.cernerdirect.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.

Hospital & facility affiliations 2

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1932172749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR",
            "address_2": "SUITE2500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013656",
            "telephone_number": "304-691-1200",
            "fax_number": "304-691-1287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR",
            "address_2": "SUITE2500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013656",
            "telephone_number": "304-691-1200",
            "fax_number": "304-691-1287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "STEPHEN",
        "middle_name": "LAWRENCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WV",
            "license": "15997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0126588000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephen.wilson@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1600 Medical Center Dr",
            "address_2": "Suite2500",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.