Brett Lee Wilson, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

2009014905 Issued in MO

Practice address

2521 Glenn Hendren Dr Ste 204
Liberty, MO 64068-3388

Phone

(816) 781-6066

NPI assigned

Aug 10, 2005

Sex

Male

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

81.21 of 100Reported as group

Quality

69.99

Promoting interoperability

99

Improvement activities

40

Cost

68.22

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1194726307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1733 COUNTY ROAD 200",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668017672",
            "telephone_number": "620-343-8044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 GLENN HENDREN DR STE 204",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640683388",
            "telephone_number": "816-781-6066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2522 W 15th Ave",
            "address_purpose": "LOCATION",
            "city": "Emporia",
            "state": "KS",
            "postal_code": "668016102",
            "country_code": "US",
            "telephone_number": "620-343-7043",
            "fax_number": "620-343-8571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRETT",
        "middle_name": "LEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KS",
            "license": "15-00245",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "2009014905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR MEDICARE",
            "identifier": "970000628",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002860A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "50797021",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooke Williams, LPC, RPT
• Camille V Williams, FNP-BC
• Janet Williams
• Karmin Williams
• Lisa Willingham
• Brian Wilson, OTR
• Jacob Wilson
• Sophie Wilson
• Rachel Wingerson, RBT
• Katelynn Wininger, RBT

• Surgical Physician Assistant in Liberty, MO
• Providers in Liberty, MO by specialty
• Surgical Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.