Grant Wilson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

079688 Issued in IA

Practice address

802 Kenyon Rd
Fort Dodge, IA 50501-5740

Phone

(515) 573-3101

NPI assigned

Sep 2, 2015

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 IA

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinity Regional Medical CenterGroup PAC ID 7315858529, 170 clinicians

Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Regional Medical Center Hospital, Fort Dodge, IA, CCN 160016
• Humboldt County Memorial Hospital Hospital, Humboldt, IA, CCN 161334

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gwilson299295@direct.unitypoint.org

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.

• Iowa Physicians Clinic Medical Foundation

  dba UnityPoint Clinic

  • General Practice Physician
  • West Des Moines, IA
  • NPI 1366425274
  Medicare reassignment Care Compare group NPD
• Trinity Regional Medical Center

  dba UnityPoint Clinic

  • Emergency Medicine Physician
  • Fort Dodge, IA
  • NPI 1073594156
  Medicare reassignment Care Compare group NPD
• Iowa Physicians Clinic Medical Foundation

  dba Unitypoint Clinic Family Medicine - Anthon

  • Rural Health Clinic/Center
  • Anthon, IA
  • NPI 1053203927

  Physician Assistant

  NPD
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

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

• Humboldt County Memorial Hospital

  • Critical Access Hospital
  • Humboldt, IA
  • NPI 1194702977
  Care Compare affiliation
• Trinity Regional Medical Center

  dba UnityPoint Health Trinity Regional Medical Center

  • General Acute Care Hospital
  • Fort Dodge, IA
  • NPI 1487759858
  Care Compare affiliation

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441152000000",
    "number": "1558738963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 KENYON RD",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015740",
            "telephone_number": "515-573-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 KENYON RD",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015740",
            "telephone_number": "515-573-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "GRANT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-02",
        "last_updated": "2015-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "079688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tricia Lynn Widlund, A.R.N.P.
• Katelin Renee Wiebersch, DPT
• Michael J Willerth, MD
• Amanda Marie Williams, OTR
• Amanda Kathryn Wilson, RN, BSN, CNOR
• James Matthew Wilson, M.D.
• Michael David Wilson, DPM
• Savannah Meredith Wiltfang, DNAP, CRNA
• Alycia Julia Wirtz
• Amy Lynette Witham, MSW

• Physician Assistant in Fort Dodge, IA
• Providers in Fort Dodge, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; 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.