NPIMap

Individual provider Active NPI

Alisha Cora Tarter Wilson, PA-C

  • Physician Assistant
  • Somerset, KY
National Provider Identifier
1760629943
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
30 Medpark Square
Suite 1
Somerset, KY 42503-3812
Phone
(606) 451-0485
Fax
(606) 451-0229
NPI assigned
Jan 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Surgical Physician Assistant 363AS0400X PA1163 KY

Addresses

Primary practice location

30 Medpark Square
Suite 1
Somerset, KY 42503-3812

Mailing address

PO Box 719
Somerset, KY 42502-0719
Phone (606) 451-0485

Other identifiers 1

IdentifierTypeStateIssuer
PA1163OtherKYKY LICENSE

Other names 1

  • Alisha Cora Tarter Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090622000297 KY Practitioner - Physician Assistant 2860543469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Kentucky College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

30 Tower Cir
Somerset, KY 42503-3476
Phone (606) 451-8644

56 Tower Cir
Somerset, KY 42503-3476
Phone (606) 677-2913

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Cumberland Physician Practices LLC CurrentSince Jan 18, 2016 Accepting new patients
Lake Cumberland Physician Practices LLC CurrentSince Jan 18, 2016 Accepting new patients
Lake Cumberland Surgery Center LP Past Accepting new patients
Lake Cumberland Cardiology Associates LLC PastSince Sep 14, 2020 Accepting new patients

Locations

30 Medpark Square Dr
Ste 1
Somerset, KY 42503
Phone (606) 451-0485

30 Tower Cir
Somerset, KY 42503
Phone (606) 451-8644

305 Medpark Dr
Somerset, KY 42503
Phone (606) 263-2912

75 Hail Knob Rd
Somerset, KY 42503
Phone (606) 678-9617

Interoperability endpoints

  • FHIR API: https://97465a19-0dc7-4ef3-9aea-f72e472d3305.gastro.prod.fhir.ema-api.com/fhir/r4/
  • Direct secure messaging: alisha.tarter.wilson.1@21269.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/21269/brand/3/csg/1/fhir/r4

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1760629943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425020719",
            "telephone_number": "606-451-0485",
            "fax_number": "606-451-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MEDPARK SQUARE",
            "address_2": "SUITE 1",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033812",
            "telephone_number": "606-451-0485",
            "fax_number": "606-451-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARTER WILSON",
        "first_name": "ALISHA",
        "middle_name": "CORA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-09",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "PA1163",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY LICENSE",
            "identifier": "PA1163",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALISHA",
            "last_name": "TARTER",
            "middle_name": "CORA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Somerset, KY

Sources for this page

Verify at the official NPI Registry.