Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Bryant Thomas Wilson, PA-C

Individual provider Physician Assistant · NPI 1013103001

Bryant Thomas Wilson, PA-C is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2005, 21 years ago. Practices with Advanced Radiology Services PC, a 252-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
21
Licensed in
MI
In the registry since
2007
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone: (616) 363-7339
Fax: (616) 361-5828
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601004603 (MI)

Record details

NPI number1013103001
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 24, 2007
Last updated in NPPESApril 18, 2013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Advanced Radiology Services Pc — 252 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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