Samuel Jerod Wilson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2024004739 Issued in MO

Practice address

1000 E Primrose St
Springfield, MO 65807-5154

Phone

(314) 269-6000

NPI assigned

Feb 6, 2024

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 MO

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lester E Cox Medical CentersGroup PAC ID 1254248917, shared by 28 NPIs, 336 clinicians

Cox-Monett Hospital IncGroup PAC ID 0345236667, 69 clinicians

Skaggs Community Hospital AssociationGroup PAC ID 5092624320, 222 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cox Medical Centers Hospital, Springfield, MO, CCN 260040
• Cox Medical Center Branson Hospital, Branson, MO, CCN 260094

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Cox-Monett Hospital, Inc.

  • Urgent Care Clinic/Center
  • Monett, MO
  • NPI 1205387289
  Medicare reassignment Care Compare group NPD
• Skaggs Community Hospital Association

  • Urgent Care Clinic/Center
  • Branson, MO
  • NPI 1255870853
  Medicare reassignment Care Compare group NPD
• Lester E Cox Medical Centers

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1447324660
  Medicare reassignment
• Lester E Cox Medical Centers

  • Urgent Care Clinic/Center
  • Ozark, MO
  • NPI 1669923884
  Medicare reassignment
• Lester E. Cox Medical Centers

  • Family Medicine Physician
  • Shell Knob, MO
  • NPI 1538334396
  Medicare reassignment
• Cox-Monett Hospital, Inc.

  • Emergency Medicine Physician
  • Monett, MO
  • NPI 1669687125
  NPD
• Lester E Cox Medical Centers

  • Neurology Physician
  • Springfield, MO
  • NPI 1023763414
  NPD
• Lester E Cox Medical Centers

  • Geriatric Medicine (Internal Medicine) Physician
  • Springfield, MO
  • NPI 1356068605
  NPD
• Lester E Cox Medical Centers

  • Urgent Care Clinic/Center
  • Lebanon, MO
  • NPI 1679067748
  NPD
• Lester E Cox Medical Centers

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1912452814
  NPD
• Lester E Cox Medical Centers

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1922126077
  NPD
• Skaggs Community Hospital Association

  • Family Medicine Physician
  • Branson, MO
  • NPI 1356291298
  NPD

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

• Lester E Cox Medical Centers

  • General Acute Care Hospital
  • Springfield, MO
  • NPI 1093740128
  Care Compare affiliation
• Lester E Cox Medical Centers

  • Land Ambulance
  • Springfield, MO
  • NPI 1114044823

  Hospital

  Care Compare affiliation
• Lester E. Cox Medical Centers

  • Air Ambulance
  • Springfield, MO
  • NPI 1578680286

  Hospital

  Care Compare affiliation
• Skaggs Community Hospital Association

  • General Acute Care Hospital
  • Branson, MO
  • NPI 1760443980
  Care Compare affiliation

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

{
    "created_epoch": "1707177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1548024029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12324 MATTHEWS LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E PRIMROSE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075154",
            "telephone_number": "314-269-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1429 W Sunshine St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658072346",
            "country_code": "US",
            "telephone_number": "417-730-5700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5100 N Towne Centre Dr",
            "address_purpose": "LOCATION",
            "city": "Ozark",
            "state": "MO",
            "postal_code": "657217479",
            "country_code": "US",
            "telephone_number": "417-730-5510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 N Old Wilderness Rd",
            "address_purpose": "LOCATION",
            "city": "Nixa",
            "state": "MO",
            "postal_code": "657149490",
            "country_code": "US",
            "telephone_number": "417-269-2227",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3525 E Battlefield St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658093435",
            "country_code": "US",
            "telephone_number": "417-269-0065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1819 S National Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658042217",
            "country_code": "US",
            "telephone_number": "417-269-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SAMUEL",
        "middle_name": "JEROD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2024004739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori J. Wilson, M.D.
• Marlana Renee Wilson
• Megan Loree Wilson, PMHNP
• Nicole R Wilson, MSW, LMSW
• Regan Wilson, PA-C
• Sara Lynn Wilson, PSY.D, LP
• Sierra R Wilson, BCBA
• Victor Warren Wilson, MD
• Lacey Marie Winchester, M.D.
• Kelli Marie Windes

• Physician Assistant in Springfield, MO
• Providers in Springfield, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.