Katie Elizabeth Wilson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2011040150 Issued in MO

Practice address

1 Childrens PL
Div Psychiatry, Child and Adolescent
Saint Louis, MO 63110-1002

Phone

(314) 286-1700

Fax

(314) 286-1777

NPI assigned

Jan 4, 2007

Last updated

Nov 15, 2021By 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 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Interoperability endpoints

• Direct secure messaging: katie.wilson.p1@direct.essehealth.nextgenshare.com

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.

• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1003856592
  Medicare reassignment
• Psych Care Consultants LLC

  • Psychiatry Physician
  • Saint Louis, MO
  • NPI 1275533853
  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1225185119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 FOREST PARK AVE",
            "address_2": "STE 4300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082138",
            "telephone_number": "314-286-1700",
            "fax_number": "314-408-2756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "address_2": "DIV PSYCHIATRY, CHILD AND ADOLESCENT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-286-1700",
            "fax_number": "314-286-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KATIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2011040150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207172503",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Childrens Pl",
            "address_2": "Div Psychiatry, Child and Adolescent",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joshua Lynn Wilson, MD
• Juanita Wilson, ANP
• Kandis-Ayanna Wilson
• Kari Wilson, MA, PLPC
• Katherine Emily Wilson, RBT
• Kayla Rose Wilson
• Kelsey Nicole Wilson, PHD
• Kenna Leann Wilson, MOT, OTR/L
• Kyesha Almonique Wilson, BCBA
• Latoya S Wilson, DMD

• Psychiatry Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.