Kelly L Wilson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA21542 Issued in CA

Practice address

5030 J St
Ste 201
Sacramento, CA 95819-3800

Phone

(916) 455-1155

NPI assigned

Apr 12, 2011

Sex

Female

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 CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baz Allergy Asthma and Sinus Center IncGroup PAC ID 6507770716, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kaweah Health Medical Center Hospital, Visalia, CA, CCN 050057

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9618/brand/1/csg/1/fhir/r4

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.

• Baz Allergy, Asthma & Sinus Center, Inc.

  • Allergy Physician
  • Fresno, CA
  • NPI 1710906995
  Medicare reassignment Care Compare group
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Woodlake, CA
  • NPI 1164517744
  Medicare reassignment
• Garcia Lee and Concepcion Medical Group Inc

  • Family Medicine Physician
  • Sacramento, CA
  • NPI 1417020579
  Medicare reassignment
• Baz Allergy, Asthma & Sinus Center

  • Allergy Physician
  • Clovis, CA
  • NPI 1396328779
  NPD
• Baz Allergy, Asthma & Sinus Center, Inc.

  • Allergy Physician
  • Visalia, CA
  • NPI 1215956396
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Delano, CA
  • NPI 1063283158
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Springville, CA
  • NPI 1386738177
  NPD
• Garcia, Lee & Concepcion Medical Group

  • Family Medicine Physician
  • West Sacramento, CA
  • NPI 1639368079
  NPD
• Baz Allergy, Asthma & Sinus Center, Inc.

  • Allergy Physician
  • Hanford, CA
  • NPI 1023037108
  NPD (past)
• Eric Tepper, MD

  • Family Medicine Physician
  • Sacramento, CA
  • NPI 1154038420
  NPD (past)

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

• Kaweah Delta Health Care District

  • General Acute Care Hospital
  • Visalia, CA
  • NPI 1588663769
  Care Compare affiliation

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

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1124318027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 J ST",
            "address_2": "STE 201",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193800",
            "telephone_number": "916-455-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 J ST",
            "address_2": "STE 201",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193800",
            "telephone_number": "916-455-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KELLY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-12",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jianna Wilson
• Jocelyn Wilson
• Jordan Wilson
• Julian Bryant Wilson
• Kathryn Wilson
• Kelly Sue Wilson
• Kersten R Wilson
• Kesha Rena Wilson, LCSW
• Lauren Wilson
• Lauren E Wilson, PNP

• Medical Physician Assistant in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.