Individual provider Active NPI

Bryan R Wilson, MD

  • Emergency Medicine Physician
  • Charlottesville, VA
National Provider Identifier
1972985299
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101289415 Issued in VA
Practice address
1215 Lee St
Charlottesville, VA 22908-0816
Phone
(434) 924-2231
Fax
(434) 924-9295
NPI assigned
Jun 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 25MA10245300 NJ
Emergency Medicine Physician 207P00000X 0101289415 VA Primary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 30830 WV
Emergency Medicine Physician 207P00000X MD461810 PA
Emergency Medicine Physician 207P00000X MT209074 PA

Addresses

Primary practice location

1215 Lee St
Charlottesville, VA 22908-0816

Mailing address

PO Box 749112
Atlanta, GA 30374-9112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ, VA3 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
I20171017002936 PA Practitioner - Emergency Medicine 9133402415 Reassigns benefits to 1 organization
I20180717002856 NJ Practitioner - Emergency Medicine 9133402415 Reassigns benefits to 3 organizations
I20260605002497 VA Practitioner - Emergency Medicine 9133402415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rutgers New Jersey Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

1021 Park Ave
Quakertown, PA 18951-0130
Phone (215) 538-4500

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD461810PAMDEmergency Medicine Physician
MT209074PAMDEmergency Medicine Physician
30830WVMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Warren Physician Group, PC CurrentSince Nov 12, 2024 Accepting new patients
St. Luke'S Warren Physician Group, PC Current Accepting new patients
St. Luke'S Warren Physician Group, PC CurrentSince Nov 12, 2024 Accepting new patients
Cooper Univeristy Emergency Physicians, PC Emergency Medicine CurrentSince Jul 1, 2018 Accepting new patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
St Luke'S Physician Group Inc CurrentSince Sep 1, 2017 Accepting new patients
St Luke'S Physician Group Inc CurrentSince Sep 1, 2017 Accepting new patients
Cooper Urgent Care, PC Emergency Medical Services CurrentSince Jul 1, 2018 Accepting new patients

Locations

318 S White Horse Pike
Audubon, NJ 08106
Phone (856) 672-6077

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

2001 Route 70 E
Cherry Hill, NJ 08003
Phone (856) 396-6257

755 Memorial Pkwy
Ste 302
Phillipsburg, NJ 08865
Phone (908) 847-6722

185 Roseberry St
Bldg 2ND
Phillipsburg, NJ 08865
Phone (908) 847-2619

185 Roseberry St
Phillipsburg, NJ 08865
Phone (908) 213-6611

310 Salem Woodstown Rd
Salem, NJ 08079
Phone (856) 339-6054

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Organizations & group practices 9

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 6

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": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1972985299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-2231",
            "fax_number": "434-924-9295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRYAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-23",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NJ",
            "license": "25MA10245300",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101289415",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WV",
            "license": "30830",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD461810",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT209074",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.