Paul Michael Wilde, PA-C, SC.D.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1002775 NCCPA Issued in GA

Practice address

550 Pope Ave
Fort Leavenworth, KS 66027-2332

Phone

(913) 684-6198

Fax

(913) 684-6128

NPI assigned

Jul 29, 2005

Last updated

Jul 13, 2026By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1558361535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5034 MUND RD",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662189147",
            "telephone_number": "913-422-8477",
            "fax_number": "913-322-4562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 POPE AVE",
            "city": "FORT LEAVENWORTH",
            "state": "KS",
            "postal_code": "660272332",
            "telephone_number": "913-684-6198",
            "fax_number": "913-684-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "credential": "PA-C, SC.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "1002775  NCCPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Weston-Clark, LPN
• Yvonne Anne Westover
• Deblyn Tchounou Wete
• Laura Ann Whaley, LSCSW
• Carol Louise Whitmore, LPN
• Gary Bretz Wilhelm, M.D.
• Mary E Willis, RN
• Jessica Marie Wilson, LPN
• Kyle Jonathan Wilson, DMD
• Paula Wilson, LPN

• Medical Physician Assistant in Fort Leavenworth, KS
• Providers in Fort Leavenworth, KS by specialty
• Medical Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.