Individual provider Active NPI

Cathy McDaniels Wilson, PH.D.

  • Clinical Psychologist
  • Columbus, OH
National Provider Identifier
1528288958
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5664 Issued in OH
Practice address
52 W 5TH Ave Ste C
Columbus, OH 43201-7200
Phone
(614) 294-1751
Fax
(614) 294-2995
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 5664 OH Primary

Addresses

Primary practice location

52 W 5TH Ave Ste C
Columbus, OH 43201-7200

Mailing address

52 W 5TH Ave Ste C
Columbus, OH 43201-7200
Phone (614) 294-1751

Other practice location 1

455 Shawnee Ln
Chillicothe, OH 45601-4145
Phone (740) 779-4888

Other identifiers 1

IdentifierTypeStateIssuer
2176096MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adena.counseling@adena.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080922000185 OH Practitioner - Clinical Psychologist 0345317194 Reassigns benefits to 1 organization
Practice locations: Columbus, OH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adena Medical Group LLCGroup PAC ID 1153456579, 384 clinicians

Practice addresses (Care Compare)

455 N Shawnee Lane
Chillicothe, OH 45601-9031
Phone (740) 779-4888

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.93 of 100Reported as group
Quality
64.42
Promoting interoperability
99
Improvement activities
40
Cost
73.2

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
5664OHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Adena Medical Group LLC CurrentSince Apr 1, 2022 Accepting new patients

Locations

4437 State Route 159
Ste 125
Chillicothe, OH 45601
Phone (740) 779-4570

455 Shawnee Ln
Chillicothe, OH 45601
Phone (740) 779-4865

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1528288958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 W 5TH AVE STE C",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432017200",
            "telephone_number": "614-294-1751",
            "fax_number": "614-294-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 W 5TH AVE STE C",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432017200",
            "telephone_number": "614-294-1751",
            "fax_number": "614-294-2995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Shawnee Ln",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "OH",
            "postal_code": "456014145",
            "country_code": "US",
            "telephone_number": "740-779-4888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDANIELS WILSON",
        "first_name": "CATHY",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "5664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2176096",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena.counseling@adena.medicity.net",
            "affiliation": "N",
            "address_1": "455 Shawnee Ln",
            "city": "Chillicothe",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456014145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.