Individual provider Active NPI

Kathy Tingle Wilson, M.D.

  • Pulmonary Disease Physician
  • Conover, NC
National Provider Identifier
1114095841
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
01566 Issued in NC
Practice address
3521 Graystone PL SE
Suite 202
Conover, NC 28613-8268
Phone
(828) 326-2660
Fax
(828) 326-2671
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 01566 NC Primary

Addresses

Primary practice location

3521 Graystone PL SE
Suite 202
Conover, NC 28613-8268

Mailing address

PO Box 890273
Charlotte, NC 28289-0273
Phone (828) 326-2600

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20080118000381 NC Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 7416040712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
University of Mississippi School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catawba Valley Medical Group IncGroup PAC ID 6305007279, 133 clinicians

Practice addresses (Care Compare)

2386 Springs Rd NE
Hickory, NC 28601-3066
Phone (828) 732-5400

50 Macedonia Church Rd a
Taylorsville, NC 28681-8414
Phone (828) 732-5300

Hospital & facility affiliations

  • Catawba Valley Medical Center Hospital, Hickory, NC, CCN 340143

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Valley Medical Group, Inc Pulmonary Disease CurrentSince Jun 13, 2016 Accepting new patients
American Respiratory Specialist, LLC Pulmonary Disease CurrentSince Sep 4, 2020 Accepting new patients
Catawba Valley Medical Group Inc CurrentSince Jun 13, 2016 Accepting new patients
Catawba Valley Medical Group, Inc Current Accepting new patients
Vicksburg Clinic LLC Past Accepting new patients
Vicksburg Clinic LLC Pulmonary Disease Past Accepting new patients

Locations

200 Rosenwald School St
Catawba, NC 28609
Phone (828) 241-2377

3521 Graystone Pl SE
Ste 202
Conover, NC 28613
Phone (828) 326-2354

810 Fairgrove Church Rd
Hickory, NC 28602
Phone (704) 326-3000

2386 Springs Rd NE
Hickory, NC 28601
Phone (828) 256-2112

50 Macedonia Church Rd
#A
Taylorsville, NC 28681
Phone (828) 732-5300

Interoperability endpoints

  • Direct secure messaging: kathy.wilson@cvmg.eclinicaldirectplus.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1114095841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 890273",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282890273",
            "telephone_number": "828-326-2600",
            "fax_number": "828-326-2671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3521 GRAYSTONE PL SE",
            "address_2": "SUITE 202",
            "city": "CONOVER",
            "state": "NC",
            "postal_code": "286138268",
            "telephone_number": "828-326-2660",
            "fax_number": "828-326-2671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KATHY",
        "middle_name": "TINGLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NC",
            "license": "01566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conover, NC

Sources for this page

Verify at the official NPI Registry.