Kathy Wilson, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

A119319 Issued in CA

Practice address

2683 Pacific Ave
Long Beach, CA 90806-2610

Phone

(323) 404-4884

NPI assigned

Jun 10, 2008

Last updated

Jan 14, 2016By 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

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: kwilson41215@altamed.direct-ci.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.

• Clinica del Socorro Medical Group,Inc.

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1215263827
  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  Medicare reassignment NPD
• Magella Medical Group, Inc.

  • Maternal & Fetal Medicine Physician
  • Long Beach, CA
  • NPI 1376640086

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Pih Health Physicians

  • Family Medicine Physician
  • Whittier, CA
  • NPI 1609233899
  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Addiction Medicine (Internal Medicine) Physician
  • Tustin, CA
  • NPI 1891981502
  NPD
• Pih Health Physicians

  • Anesthesiology Physician
  • Downey, CA
  • NPI 1447931506
  NPD
• Pih Health Physicians

  • Family Medicine Physician
  • Whittier, CA
  • NPI 1720232465
  NPD
• Bellatriss Nursing Inc

  • Obstetrics & Gynecology Physician
  • Sierra Madre, CA
  • NPI 1376569830
  NPD (past)
• Tri-State Community Healthcare Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1457275539
  NPD (past)

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452729600000",
    "number": "1245490721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2683 PACIFIC AVE",
            "address_2": "SUITE A",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062610",
            "telephone_number": "323-404-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2683 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062610",
            "telephone_number": "323-404-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KATHY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2016-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A119319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaimion Wilson
• James Patrick Wilson, MFC28227
• Jerry W Wilson, LMFT
• Judith Ruth Wilson, NP
• Justin Wilson, CCAPP CERTIFIED
• Kwame Nigel Wilson
• La Quanda Wilson
• Lashonda Wilson
• Lisa Virginia Wilson
• Madison Elizabeth Wilson, MA

• Obstetrics & Gynecology Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; 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.