Organization Active NPI

Wilson Urology PA

  • Urology Physician
  • Wilson, NC
National Provider Identifier
1992762728
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
WILSON UROLOGY PA
Practice address
2509 Wooten Blvd SW
Wilson, NC 27895
Phone
(252) 243-5511
Fax
(252) 399-7575
NPI assigned
Apr 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. James B Rounder Jr., MD
Title
Vice President
Phone
(252) 243-5511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X NC Primary

Addresses

Primary practice location

2509 Wooten Blvd SW
Wilson, NC 27895

Mailing address

PO Box 3329
Wilson, NC 27895
Phone (252) 243-5511

Other identifiers 1

IdentifierTypeStateIssuer
890213FMedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992762728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3329",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "27895",
            "telephone_number": "252-243-5511",
            "fax_number": "252-399-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 WOOTEN BLVD SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "27895",
            "telephone_number": "252-243-5511",
            "fax_number": "252-399-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON UROLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROUNDER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "252-243-5511",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890213F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.