Timothy Allen Wilson, M.D.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

R3A87 Issued in MO

Practice address

8930 Evanston Ave
Kansas City, MO 64138-4732

Phone

(816) 617-1398

Fax

(816) 832-8236

NPI assigned

Jun 26, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Geriatric Medicine

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: timothy.wilson@khindirect.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.

• Inity Ccprx Home Care LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Kansas City, MO
  • NPI 1285119545
  Medicare reassignment NPD
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1619173549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8930 EVANSTON AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641384732",
            "telephone_number": "816-617-1398",
            "fax_number": "816-832-8236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8930 EVANSTON AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641384732",
            "telephone_number": "816-617-1398",
            "fax_number": "816-832-8236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9027 SW 208th St",
            "address_purpose": "LOCATION",
            "city": "Trimble",
            "state": "MO",
            "postal_code": "644927846",
            "country_code": "US",
            "telephone_number": "816-790-3579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TIMOTHY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R3A87",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MO",
            "license": "R3A87",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald W. Wilson, LSCSW
• Stephanie M. Wilson, D.D.S.
• Susan Bernadette Wilson, PH.D.
• Sydney Jay Wilson, MA, BCBA, LBA
• Thad Rahn Wilson, FNP
• Whitney Elaine Wilson, LCSW
• Winnie H Wilson
• Zachary Wilson, MA, LPC
• David A Wilt, MD
• Polly Josephine Wimer, RN MSN CPNP

• Geriatric Medicine (Family Medicine) Physician in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Geriatric Medicine (Family Medicine) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.