Nicolas Ray Wilson, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810009277 Issued in VA

Practice address

931 S Main St Ste E
#288
Kernersville, NC 27284-7459

Phone

(336) 993-6000

NPI assigned

Jul 29, 2013

Last updated

Mar 26, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Salisbury Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Kernersville, NC
  • NPI 1982652723
  NPD

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1649612854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 S MAIN ST STE E",
            "address_2": "#288",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847459",
            "telephone_number": "336-462-8523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 S MAIN ST STE E",
            "address_2": "#288",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847459",
            "telephone_number": "336-993-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "NICOLAS",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-29",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810009277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal L Williams
• Davette Traci Williams, RN
• Imani Williams
• Nykia R Williams
• Paige Williams
• Katie Scott Wingate, NP-C
• Winston Eye Associates OD PA
• Witherspoon Home Care LLC
• Amal Wood, LCMHCA
• Paula Plaster Wood, NP-C

• Clinical Psychologist in Kernersville, NC
• Providers in Kernersville, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.