BRADLEY A WILSON (NPI# 1528046141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528046141 |
| Entity Type | Individual |
| Full Name | BRADLEY A WILSON |
| Credential | MD |
| Practice Address |
1000 Health Center Dr Ste 101 Mattoon IL 61938-4644 |
| Mailing Address |
1005 Health Center Dr Ste 201 Mattoon IL 61938-4693 |
| Practice Telephone | 2172584020 |
| Practice Fax Number | 2172584023 |
| Mailing Telephone | 2172386055 |
| Mailing Fax Number | 2172582216 |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2020-09-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 36118588 | IL | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 2005016227 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | AETNA | 7470693 | 01 |
| IL | MEDICARE GRP NUMBER | 207988 | 01 |
| IL | MEDICARE GRP NUMBER | 208959 | 01 |
| IL | RR GROUP | CE9335 | 01 |
| IL | RR MEDICARE NUMBER | P00396925 | 01 |
| MO | HEALTHLINK | 718653 | 01 |
| MO | 207215500 | 05 | |
| MO | MERCY HEALTH PLANS | I37919 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 200 Professional Plz, Mattoon, IL 619389280 | 2172384850 | |
| 500 Health Center Drive, Ste. 304, Mattoon, IL 619380372 | 2172584020 | 2172584023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235519984 | Bradley Craig Wilson | Military Health Care Provider | 2807 Montclair Ave, Pascagoula, MS 39567-5287 | 2015-06-08 |
| 1699061598 | Bradley Paul Wilson | Student in an Organized Health Care Education/Training Program | 349 17th Ave, San Francisco, CA 94121-2312 | 2011-06-20 |
| 1407084791 | Bradley Allen Wilson | Urology | 500 E Robinson Suite 1300, Norman Urology Associates, PC, Norman, OK 73071-6694 | 2009-06-25 |
| 1053329185 | Bradley Rix Wilson | Dentist | 2077 S Gessner Rd, Suite 125, Houston, TX 77063-1147 | 2006-08-04 |
| 1225020878 | Bradley C Wilson | Family Medicine | 7756 State Route 37 E, New Lexington, OH 43764-9512 | 2005-08-19 |
| 1366078990 | Bradley Clark Wilson | Case Manager/Care Coordinator | 2005 Ashland Ave, Toledo, OH 43620-1703 | 2020-03-16 |
| 1508339987 | Bradley Russell Wilson | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2019-01-08 |
| 1386985133 | Bradley W Wilson | Nurse Anesthetist, Certified Registered | 300 North Ave, Battle Creek, MI 49017-3307 | 2013-03-04 |
| 1609130954 | Bradley Lyle Wilson | Family Medicine | 4771 S Cleveland Ave, Fort Myers, FL 33907 | 2012-07-02 |
| 1174810824 | Bradley Jay Wilson | Radiology | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2011-07-01 |
| Street Address |
1000 HEALTH CENTER DR STE 101 |
| City | MATTOON |
| State | IL |
| Zip Code | 61938-4644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285054031 | Todd Bierman | Surgery | 1000 Health Center Dr Ste 101, Mattoon, IL 61938 | 2014-04-21 |
| 1699923961 | Bethany Amelia Cottrill | Physician Assistant | 1000 Health Center Dr Ste 101, Mattoon, IL 61938-4644 | 2008-08-28 |
| 1467568345 | Kellie Jones-monahan | Surgery | 1000 Health Center Dr Ste 101, Mattoon, IL 61938-4644 | 2006-08-22 |
| 1386750685 | Curtis Green | Surgery | 1000 Health Center Dr Ste 101, Mattoon, IL 61938-4644 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043831134 | St Anthony's Memorial Hospital of The Hospital Sisters of The Third Or | Clinic/Center | 101 Coles Centre Pkwy, Ste 101, Mattoon, IL 61938 | 2020-04-30 |
| 1215436449 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 300 Coles Centre Pkwy, Mattoon, IL 61938 | 2018-02-02 |
| 1841707726 | Mattoon Chiropractic LLC | Chiropractor | 905 Remington Rd, Mattoon, IL 61938 | 2018-01-02 |
| 1164892758 | Dr. Charles L. Schnibben Ltd. | Dentist | 1502 Lakeland Blvd, Mattoon, IL 61938 | 2015-09-25 |
| 1982000139 | Judy A. Clark | Hearing Instrument Specialist | 1302 Charleston Avenue, Audibel Hearing Aids, Mattoon, IL 61938 | 2014-11-17 |
| 1023419884 | Christopher Steven Lillie | Physician Assistant | 200 Richmond Ave East, Family Medical Center, Mattoon, IL 61938 | 2014-09-11 |
| 1295055168 | Jennifer Harp | Mechanotherapist | 232 Richmond Ave East, Mattoon, IL 61938 | 2010-06-02 |
| 1447482682 | Gene Clark Hearing Aid Service | Hearing Aid Equipment | 208 Wabash, Mattoon, IL 61938 | 2009-08-21 |
| 1326229774 | Central Illinois Family Health Center | Nurse Practitioner | 10555 East County Rd 800 North, Mattoon, IL 61938 | 2007-11-14 |
| 1568656445 | Bernie Ranchero | Family Medicine | 1004 Health Center Dr Ste 210, Mattoon, IL 61938 | 2007-09-04 |
| Find all providers in zip 61938 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285054031 | Todd Bierman | Surgery | 1000 Health Center Dr Ste 101, Mattoon, IL 61938 | 2014-04-21 |
| 1477671519 | Sarah Bush Lincoln Health Center | Surgery | 500 Health Center Dr, Suite 301, Mattoon, IL 61938-9258 | 2007-03-27 |
| 1467568345 | Kellie Jones-monahan | Surgery | 1000 Health Center Dr Ste 101, Mattoon, IL 61938-4644 | 2006-08-22 |
| 1386750685 | Curtis Green | Surgery | 1000 Health Center Dr Ste 101, Mattoon, IL 61938-4644 | 2006-08-21 |
| 1033154109 | Uretz John Oliphant | Surgery | 200 Lerna Rd S, Mattoon, IL 61938-9388 | 2006-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1376167809 | Francesco Bajani | Surgery | 664 N Dearborn St Apt 2f, Chicago, IL 60654-3848 | 2020-06-01 |
| 1972123099 | Andrea Liu | Surgery | 5841 S Maryland Ave Mc6040, Chicago, IL 60637-1443 | 2020-04-18 |
| 1750917183 | Alberto Maria Fratti | Surgery | 901 S Ashland Ave Apt 711, Chicago, IL 60607-4088 | 2020-03-17 |
| 1841845047 | Barijuve Surgical LLC | Surgery | 380 E Northwest Hwy Ste 200, Des Plaines, IL 60016-2274 | 2019-08-05 |
| 1164081782 | Sean Park | Surgery | 1739 Tudor Ln Unit 308, Northbrook, IL 60062-3778 | 2019-06-07 |
| 1376014175 | Edwardsville Physicians Group LLC | Surgery | 441 South State Route 157 Suite 102, Edwardsville, IL 62025-4012 | 2018-12-06 |
| 1316421324 | Erica Lester | Surgery | John H Stroger, 1969 Ogden Ave, Chicago, IL 60612 | 2018-09-17 |
| 1023513389 | Crystal Siyu Zhang | Surgery | 2160 S 1st Ave Bldg 3210, Maywood, IL 60153 | 2018-03-28 |
| 1376047381 | Richard Lawrence Nelson | Surgery | 1603 W. Taylor St., Room 983, Chicago, IL 60612-4394 | 2018-03-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.