Active NPI
Thomas Wilson
- Certified Registered Nurse Anesthetist
- Paducah, KY
National Provider Identifier
1700742830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 4049423
- Practice address
- 2501 Kentucky Ave
Paducah, KY 42003-3813 - Phone
- (270) 575-2100
- NPI assigned
- Jan 2, 2026
- Last updated
- Jan 2, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 4049423 | KY | Primary |
Addresses
Primary practice location
2501 Kentucky Ave
Paducah, KY 42003-3813
Mailing address
1925 S 25TH St
Paducah, KY 42003-2948
Phone (706) 975-4182
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2501 Kentucky Ave
Paducah, KY 42003-3813
Phone (270) 575-2100
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4049423 | KY | MD | Certified Registered Nurse Anesthetist |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Paducah, KY
- NPI 1902373772
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Paducah, KY
- NPI 1730264128
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1767312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767312000000",
"number": "1700742830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1925 S 25TH ST",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420032948",
"telephone_number": "706-975-4182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 KENTUCKY AVE",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420033813",
"telephone_number": "270-575-2100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "THOMAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-01-02",
"last_updated": "2026-01-02",
"certification_date": "2026-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "KY",
"license": "4049423",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Paducah, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.