Michael David Wilson, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

101632 Issued in IA

Practice address

804 Kenyon Rd
Fort Dodge, IA 50501-5742

Phone

(515) 302-8700

Fax

(515) 302-8701

NPI assigned

Jun 23, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Health Hospital, Lawton, OK, CCN 370056
• Southwestern Medical Center Hospital, Lawton, OK, CCN 370097

Merit-based Incentive Payment System (MIPS)

Final score

50 of 100Reported as individual

Quality

0

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Lawton Family Foot Clinic Inc

  • Podiatrist
  • Lawton, OK
  • NPI 1720181621
  Medicare reassignment NPD

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

• Comanche County Hospital Authority

  • Land Ambulance
  • Walters, OK
  • NPI 1285181610

  Hospital

  Care Compare affiliation
• Comanche County Hospital Authority

  • General Acute Care Hospital
  • Lawton, OK
  • NPI 1720022379
  Care Compare affiliation
• Comanche County Hospital Authority

  • Land Ambulance
  • Lawton, OK
  • NPI 1770525883

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1326664533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 GRANDVIEW DR",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505017875",
            "telephone_number": "509-845-3588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 KENYON RD",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015742",
            "telephone_number": "515-302-8700",
            "fax_number": "515-302-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IA",
            "license": "101632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J Willerth, MD
• Amanda Marie Williams, OTR
• Amanda Kathryn Wilson, RN, BSN, CNOR
• Grant Wilson, PA-C
• James Matthew Wilson, M.D.
• Savannah Meredith Wiltfang, DNAP, CRNA
• Alycia Julia Wirtz
• Amy Lynette Witham, MSW
• Breannon Wiuff
• Donna Ann Wong

• Podiatrist in Fort Dodge, IA
• Providers in Fort Dodge, IA by specialty
• Podiatrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.
• 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.