Adam Spach Wilson, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MD00034230 Issued in WA

Practice address

1405 SE 164TH Ave Ste 102
Vancouver, WA 98683-9644

Phone

(360) 256-4425

Fax

(360) 254-1844

NPI assigned

Mar 23, 2006

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

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in WA

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

Otolaryngology

Education

North Carolina Medical School, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050
• Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: awilson75069@direct.peacehealth.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.

• Peacehealth

  • Surgery Physician
  • Vancouver, WA
  • NPI 1609061969
  Medicare reassignment Care Compare group NPD
• Peacehealth

  • Multi-Specialty Clinic/Center
  • Longview, WA
  • NPI 1720056187
  Medicare reassignment NPD

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

• Legacy Salmon Creek Hospital

  • Clinic/Center
  • Vancouver, WA
  • NPI 1356357784

  Hospital

  Care Compare affiliation
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829
  Care Compare affiliation
• Peacehealth

  • Cardiovascular Disease Physician
  • Vancouver, WA
  • NPI 1003194911

  Hospital

  Care Compare affiliation
• Peacehealth

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999
  Care Compare affiliation

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790745933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 SE 164TH AVE STE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839644",
            "telephone_number": "360-256-4425",
            "fax_number": "360-254-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 SE 164TH AVE STE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839644",
            "telephone_number": "360-256-4425",
            "fax_number": "360-254-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ADAM",
        "middle_name": "SPACH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD00034230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST",
            "identifier": "98683A007",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE HMOO",
            "identifier": "300151208",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE CROSS OF OR",
            "identifier": "011826007",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8197287",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA DEPT OF LABOR & INDUST",
            "identifier": "0130871",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Lynn Willoughby, M.D.
• Matt Wills
• Lisa Jean Willts, P.T.
• Wilson Chiropractic Clinic, Inc
• Jaime Jose Wilson-Chiru, M.D.
• Allison Wilson
• Austin G Wilson, CNM
• Brian Lee Wilson, LMP
• Brianne Wilson, CCC-SLP
• Brittany Wilson, RDH

• Otolaryngology Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Otolaryngology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.