Scott G Willson, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

04-32856 Issued in KS

Practice address

10000 College Blvd Ste 250
Overland Park, KS 66210-1435

Phone

(913) 653-3614

Fax

(913) 232-7742

NPI assigned

Apr 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702684800000",
    "number": "1013136860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 COLLEGE BLVD STE 250",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101435",
            "telephone_number": "913-653-3614",
            "fax_number": "913-232-7742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 COLLEGE BLVD STE 250",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101435",
            "telephone_number": "913-653-3614",
            "fax_number": "913-232-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLSON",
        "first_name": "SCOTT",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2023-12-16",
        "certification_date": "2023-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "KS",
            "license": "04-32856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417689670",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassandra Willnauer
• Charles Paul Willnauer, M.D.
• Janet G. Willoughby, B.S. IN O.T.
• Laura Willoughby, RPT
• Willow Medical LLC
• Tracie Willson, APRN
• Michael Allen Wilmore, D.C.
• Alayna Marie Wilson
• Alisha Kaye Wilson, APRN NP-C
• Cassandra Wilson, LMSW

• General Practice Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• General Practice Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.