Michael Wilson

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

DO2874 Issued in NV

Practice address

6071 W Outer Dr
Detroit, MI 48235-2624

Phone

(313) 966-1941

Fax

(313) 966-4204

NPI assigned

Mar 18, 2016

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 NV

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

Pain ManagementAlso: Anesthesiology

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Nevada Pain Center (Kim) PCGroup PAC ID 5193702090, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EAIIBA

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.

• Southern Nevada Pain Center Kim PC

  • Interventional Pain Medicine Physician
  • Las Vegas, NV
  • NPI 1073624011
  Medicare reassignment Care Compare group NPD
• Centennial Hills Hospital Medical Center

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1487771812
  NPD (past)
• Desert Springs Hospital

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1154317964
  NPD (past)
• Dignity Health

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1447393152
  NPD (past)
• Sunrise Mountainview Hospital, Inc.

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1831143817
  NPD (past)

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1912368937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6071 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352624",
            "telephone_number": "313-966-1941",
            "fax_number": "313-966-4204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6071 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352624",
            "telephone_number": "313-966-1941",
            "fax_number": "313-966-4204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-18",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NV",
            "license": "DO2874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Wilson
• Kimberly Antionettte Wilson
• Lanecia Wilson, RN BSN OCN
• Leslie Marie Wilson, LLBSW
• Masao Roy Wilson, M.D.
• Natasha Wilson, LMSW
• Philshanwa Wilson
• Rahzaun-James Terrance Wilson, LLBSW
• Reandylyn Wilson
• Renee Tanya Wilson, MA, LLPC

• Pain Medicine (Anesthesiology) Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Pain Medicine (Anesthesiology) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; 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.