Kevin Wilson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

09926830 Issued in CO

Practice address

4455 E 12TH Ave
Denver, CO 80220-2415

Phone

(303) 504-6500

NPI assigned

Aug 3, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mental Health Center of Denver

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Denver, CO
  • NPI 1396566444
  Medicare reassignment NPD
• Mental Health Center of Denver

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Denver, CO
  • NPI 1407643679
  NPD
• Mental Health Center of Denver

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Denver, CO
  • NPI 1629664354
  NPD

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

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598745600000",
    "number": "1043798804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 E 12TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802202415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 E 12TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802202415",
            "telephone_number": "303-504-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-03",
        "last_updated": "2020-08-30",
        "certification_date": "2020-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09926830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Wilson, LCSW
• Justin Wilson
• Katherine Nelson Wilson, PA
• Katherine Patrice Wilson, MOTR/L
• Katie Wilson, RD, IBCLC
• Khristine Renee Wilson, LPN
• Laura L Wilson, RN
• Laura Marie Wilson, MA, CCC-SLP
• Madeleine Wilson
• Marissia Elizabeth Wilson, NP

• Clinical Social Worker in Denver, CO
• Providers in Denver, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2020; 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.