Bonnie C Wilson, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

L005078 Issued in NC

Practice address

1821 Martin Luther King Pkwy
Durham, NC 27707-6336

Phone

(919) 748-4990

NPI assigned

May 13, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Breakthrough Physical Therapy Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1558598532
  NPD (past)

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

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1962858480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PERIMETER PARK DR",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275600198",
            "telephone_number": "984-215-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 MARTIN LUTHER KING PKWY",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076336",
            "telephone_number": "919-748-4990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 Knox Way",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275176080",
            "country_code": "US",
            "telephone_number": "919-960-6094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BONNIE",
        "middle_name": "C",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-13",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L005078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Wilson
• Allen Wilson
• Alyssa Wilson
• Annika Marie Wilson, CCC-SLP
• Ashley B. Wilson, LCMHC-A
• Catherine Alexander Wilson, PT, DPT, MSPH
• Christina L Wilson, LQP, MSW, LCSW, LCAS
• Duncan Scott Wilson
• Geargin Britten Wilson, MD
• Gina Marie Wilson, ARNP

• Registered Dietitian in Durham, NC
• Providers in Durham, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.