Thomas William Wilder, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

04-28646 Issued in KS

Practice address

8919 Parallel Pkwy Ste 270
Kansas City, KS 66112-1655

Phone

(913) 334-6800

Fax

(913) 334-0875

NPI assigned

May 1, 2006

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 KS

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

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.

• Prime Healthcare Physician Services - Providence Inc

  • General Practice Physician
  • Shawnee, KS
  • NPI 1356683213

  Surgery

  Medicare reassignment NPD
• Prime Healthcare Physician Services - Providence Inc

  • General Practice Physician
  • Leavenworth, KS
  • NPI 1972119741
  NPD
• Central Kansas Medical Center

  • Family Medicine Physician
  • Great Bend, KS
  • NPI 1467402040
  NPD (past)
• Central Kansas Medical Center

  • Surgery Physician
  • Great Bend, KS
  • NPI 1881634970
  NPD (past)
• Providence Care Inc

  • Family Medicine Physician
  • Kansas City, KS
  • NPI 1477860112
  NPD (past)

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1518924653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8919 PARALLEL PKWY STE 270",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661121655",
            "telephone_number": "913-334-6800",
            "fax_number": "913-334-0875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8919 PARALLEL PKWY STE 270",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661121655",
            "telephone_number": "913-334-6800",
            "fax_number": "913-334-0875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3550 S 4th St Ste 115",
            "address_purpose": "LOCATION",
            "city": "Leavenworth",
            "state": "KS",
            "postal_code": "660485061",
            "country_code": "US",
            "telephone_number": "913-334-6800",
            "fax_number": "913-334-0875",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7255 Renner Rd",
            "address_purpose": "LOCATION",
            "city": "Shawnee",
            "state": "KS",
            "postal_code": "662173043",
            "country_code": "US",
            "telephone_number": "913-334-6800",
            "fax_number": "913-334-0875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILDER",
        "first_name": "THOMAS",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KS",
            "license": "04-28646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100370340B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carrie Lynn Wieneke Broghammer, M.D.
• Tracy Wiesehan, LMSW
• Sharee Ann Wiggins, NP
• Jonathan Wilcher, MD
• Chloe Wilder
• Jazmin Monique Wiley, APRN
• Mark A Wiley, MD
• Jordan Allen Wilkerson, MD
• Ashton Wilkin, CRNA
• Everett James Wilkinson Jr., DO

• Surgery Physician in Kansas City, KS
• Providers in Kansas City, KS by specialty
• Surgery Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.