Individual provider Active NPI

Michael Ray Wilkerson, MD

  • Emergency Medicine Physician
  • Jackson, TN
National Provider Identifier
1326362997
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
47611 Issued in TN
Practice address
294 Summar Dr
Jackson, TN 38301-3915
Phone
(731) 423-1932
Fax
(731) 410-0367
NPI assigned
Mar 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD-17806 HI
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 47611 TN Primary

Addresses

Primary practice location

294 Summar Dr
Jackson, TN 38301-3915

Mailing address

294 Summar Dr
Jackson, TN 38301-3915
Phone (731) 423-1932

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121010000156 TN Practitioner - Emergency Medicine 3375792278 Reassigns benefits to 1 organization
I20141231000011 HI Practitioner - Family PracticePractitioner - Emergency Medicine 3375792278 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Queens North Hawaii Community HospitalGroup PAC ID 0143116293, 102 clinicians

Practice addresses (Care Compare)

67-1125 Mamalaho Hwy
Kamuela, HI 96743-8496
Phone (808) 881-4400

Hospital & facility affiliations

  • Hilo Benioff Medical Center Hospital, Hilo, HI, CCN 120005
  • North Hawaii Community Hospital, Inc Hospital, Kamuela, HI, CCN 120028
  • Honoka'a Hospital and Skilled Nursing Hospital, Honokaa, HI, CCN 121307
  • Kohala Hospital Hospital, Kapaau, HI, CCN 121302

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hilo Benioff Medical Center CurrentSince Jun 11, 2022 Accepting new patients
Kauai Veterans Memorial Hospital CurrentSince Jun 21, 2016 Accepting new patients
Kauai Veterans Memorial Hospital Current Accepting new patients
Queens North Hawaii Community Hospital CurrentSince Oct 1, 2020 Accepting new patients
Honokaa Hospital & Skilled Nursing CurrentSince Dec 23, 2019 Accepting new patients
Hawaii Emergency Physicians Associated Inc Emergency Medicine CurrentSince Oct 5, 2014 Accepting new patients
Honokaa Hospital & Skilled Nursing CurrentSince Dec 23, 2019 Accepting new patients
Hilo Benioff Medical Center CurrentSince Jun 11, 2022 Accepting new patients
Hilo Benioff Medical Center Current Accepting new patients
Kau Hospital CurrentSince Jun 11, 2022 Accepting new patients
North Hawaii Community Hospital, Inc CurrentSince Oct 1, 2020 Accepting new patients
Kau Hospital CurrentSince Jun 11, 2022 Accepting new patients
Emergency Medical Care Facilities PC Emergency Medicine Past Accepting new patients
Midpacific Hospitalists LLC Past Accepting new patients

Locations

1285 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3878

1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000

45-547 Plumeria St
Honokaa, HI 96727
Phone (808) 775-7211

56-117 Pualalea St
Kahuku, HI 96731
Phone (808) 293-9221

640 Ulukahiki St
Kailua, HI 96734
Phone (808) 261-3326

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1326362997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013915",
            "telephone_number": "731-423-1932",
            "fax_number": "731-410-0367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013915",
            "telephone_number": "731-423-1932",
            "fax_number": "731-410-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "MICHAEL",
        "middle_name": "RAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-25",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "MD-17806",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "47611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.