Ryan Guy Wilson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-769 Issued in ID

Practice address

750 N Syringa St Ste 100
Post Falls, ID 83854-5275

Phone

(208) 262-2600

Fax

(208) 262-2700

NPI assigned

Oct 21, 2008

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Idaho Day Surgery LLCGroup PAC ID 0840101218, 87 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Specialty Hospital Hospital, Post Falls, ID, CCN 130066
• Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• North Idaho Day Surgery LLC

  • General Acute Care Hospital
  • Post Falls, ID
  • NPI 1104824739
  Medicare reassignment Care Compare group

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

• Kootenai Health, Inc.

  • General Acute Care Hospital
  • Coeur D Alene, ID
  • NPI 1992798409
  Care Compare affiliation
• North Idaho Day Surgery LLC

  • Multi-Specialty Clinic/Center
  • St Maries, ID
  • NPI 1093674301

  Hospital

  Care Compare affiliation
• North Idaho Day Surgery LLC

  • General Acute Care Hospital
  • Post Falls, ID
  • NPI 1104824739
  Care Compare affiliation
• North Idaho Day Surgery LLC

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Post Falls, ID
  • NPI 1649123589

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1417109695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1593 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545326",
            "telephone_number": "208-262-2498",
            "fax_number": "208-262-7461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N SYRINGA ST STE 100",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545275",
            "telephone_number": "208-262-2600",
            "fax_number": "208-262-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 W Dalton Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838158600",
            "country_code": "US",
            "telephone_number": "208-209-2060",
            "fax_number": "208-209-2070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15622 N Highway 41",
            "address_purpose": "LOCATION",
            "city": "Rathdrum",
            "state": "ID",
            "postal_code": "838588710",
            "country_code": "US",
            "telephone_number": "208-687-4878",
            "fax_number": "208-687-4879",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "RYAN",
        "middle_name": "GUY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-21",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417109695",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Wilkerson, LMT
• Taylor Noelle Wilkinson, MD
• Laurie Williams
• Rebecca Williams, DC
• Russell Thomas Wilson, DDS, MSD
• Antoinette Wilton, LCSW
• James Peter Winter, MD
• Jessica Witten
• Walter Wolf, PTA, PES, CES
• Emalee Katherine Wolk, CF-SLP

• Physician Assistant in Post Falls, ID
• Providers in Post Falls, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.