Ronald L Wilson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

22453 Issued in KY

Practice address

4620 Village Square Drive
Suite 101
Paducah, KY 42001-7501

Phone

(270) 442-8575

Fax

(270) 442-8783

NPI assigned

Mar 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ronaldwilson@ppcpsc.allscriptsdirect.net

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.

• Baptist Health Medical Group Inc

  • Hospitalist Physician
  • Paducah, KY
  • NPI 1992108682

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1376511063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 734839",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606734839",
            "telephone_number": "502-253-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 VILLAGE SQUARE DRIVE",
            "address_2": "SUITE 101",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017501",
            "telephone_number": "270-442-8575",
            "fax_number": "270-442-8783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "RONALD",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "22453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ID NUMBER",
            "identifier": "000000062924",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64224538",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rwilson9316@bhkydirect.com",
            "affiliation": "N",
            "address_1": "4620 Village Square Drive",
            "address_2": "Suite 101",
            "city": "Paducah",
            "state": "KY",
            "country_code": "US",
            "postal_code": "420017501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kalmece Tehran Wilson
• Lauradell Hogancamp Wilson, D.C.
• Melissa Wilson, APRN
• Michelle Ross Wilson, APRN
• Richard Scott Wilson, M.D.
• Shannon Wilson, PHARM.D
• Thomas Wilson
• Charles F Winkler, MD
• Michael Allen Winters, DC
• Ragan Harris Winters, OTD

• Internal Medicine Physician in Paducah, KY
• Providers in Paducah, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.