Individual provider Active NPI

Brian L Wilkinson

  • Anatomic Pathology & Clinical Pathology Physician
  • Meridian, MS
National Provider Identifier
1942300959
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
14827 Issued in MS
Practice address
1512 20TH Ave
Meridian, MS 39301-4124
Phone
(601) 484-7740
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 00020687 AL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 14827 MS Primary

Addresses

Primary practice location

1512 20TH Ave
Meridian, MS 39301-4124

Mailing address

PO Box 3780
Tupelo, MS 38803-3780
Phone (601) 483-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, TX, OK3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20190213001626 LA Practitioner - Pathology 4284604752 Reassigns benefits to 1 organization
I20230106001881 TX Practitioner - Pathology 4284604752
I20251013002496 OK Practitioner - Pathology 4284604752

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Alabama School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Delta Pathology Group LLCGroup PAC ID 4789639089, 28 clinicians

Practice addresses (Care Compare)

1301 E Lincoln Rd
Idabel, OK 74745-7300
Phone (318) 841-9555

2915 Missouri Ave
Shreveport, LA 71109-4327
Phone (318) 364-2000

Merit-based Incentive Payment System (MIPS)

Final score
71.66 of 100Reported as group
Quality
66.66
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00020687ALMDAnatomic Pathology & Clinical Pathology Physician
14827MSMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Tissue/Cytology Group, PLLC Anatomic Pathology & Clinical Pathology Current Accepting new patients
The Delta Pathology Group LLC Anatomic Pathology & Clinical Pathology Current Accepting new patients
The Delta Pathology Group, L.L.C. Past Accepting new patients

Locations

2915 Missouri Ave
Shreveport, LA 71109
Phone (318) 364-2000

3290 Knight St
Shreveport, LA 71105
Phone (318) 621-8820

1512 20th Ave
Meridian, MS 39301
Phone (601) 483-8300

1301 E Lincoln Rd
Idabel, OK 74745
Phone (580) 208-3103

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Organizations & group practices 4

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1942300959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3780",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388033780",
            "telephone_number": "601-483-8300",
            "fax_number": "601-484-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 20TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014124",
            "telephone_number": "601-484-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "BRIAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AL",
            "license": "00020687",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MS",
            "license": "14827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.