Kristin Leigh Wilson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

17988 Issued in NV

Practice address

15 McCabe Dr Ste 100
Reno, NV 89511-4815

Phone

(775) 982-5000

Fax

(775) 982-3970

NPI assigned

May 17, 2011

Last updated

Feb 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwilson143834@direct.renown.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Care Services LLC

  dba Community Care Services

  • Internal Medicine Physician
  • Reno, NV
  • NPI 1720031768
  Medicare reassignment NPD
• Community Care Services LLC

  dba Renown Radiology

  • Diagnostic Radiology Physician
  • Reno, NV
  • NPI 1053272989
  NPD
• Community Care Services LLC

  dba Renown Anesthesiology

  • Anesthesiology Physician
  • Reno, NV
  • NPI 1386023935
  NPD
• Community Care Services LLC

  dba Renown Children's

  • Pediatrics Physician
  • Reno, NV
  • NPI 1497226823
  NPD (past)

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

{
    "created_epoch": "1305590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1164715579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MILL ST # MS 14",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MCCABE DR STE 100",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895114815",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-3970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KRISTIN",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-17",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A112091",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "17988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164715579",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer M Wilson, MD
• Kathy M.O. Wilson, MS, MFTI, LADCI
• Kayla Dawn Wilson, BCBA
• Kimberly Grace Wilson, CSTFA
• Kristal Wilson
• Linda Wilson
• Lori Rhae Wilson
• Marquez Ervin Wilson, PSYD
• McKenzie James Wilson, DO
• Morika Ana Wilson

• Pediatrics Physician in Reno, NV
• Providers in Reno, NV by specialty
• Pediatrics Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.