Organization Active NPI

Kathy Wilson, M.D., P. a.

  • Sleep Medicine (Internal Medicine) Physician
  • Kerrville, TX
National Provider Identifier
1073538864
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
Legal business name
KATHY WILSON, M.D., P. A.
Practice address
703 Hill Country Dr
Suite 302
Kerrville, TX 78028-5904
Phone
(830) 792-1132
Fax
(830) 792-7747
NPI assigned
Jul 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Authorized official

Name
Kathy Rose Wilson, M. D.
Title
President
Phone
(830) 792-1132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RS0012X TX Primary

Addresses

Primary practice location

703 Hill Country Dr
Suite 302
Kerrville, TX 78028-5904

Mailing address

PO Box 291826
Kerrville, TX 78029-1826
Phone (830) 792-1132

Other identifiers 2

IdentifierTypeStateIssuer
DC8043OtherTXMEDICARE RAILROAD GROUP
P00191112OtherTXMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315000157 TX Part B Supplier - Clinic/Group Practice 7719876028 Receives reassigned benefits from 4 practitioners
Practice locations: Austin, TX; Kerrville, TX

National Provider Directory

National Provider Directory

Locations

703 Hill Country Dr
Ste 302
Kerrville, TX 78028
Phone (830) 792-1132

710 Water St
Ste 507
Kerrville, TX 78028
Phone (830) 792-1132

710 Water St
Ste 506
Kerrville, TX 78028
Phone (830) 257-3467

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1073538864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 291826",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780291826",
            "telephone_number": "830-792-1132",
            "fax_number": "830-792-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 HILL COUNTRY DR",
            "address_2": "SUITE 302",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285904",
            "telephone_number": "830-792-1132",
            "fax_number": "830-792-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHY WILSON, M.D., P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "830-792-1132",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD GROUP",
            "identifier": "DC8043",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00191112",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kerrville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.