John Michael Wilson

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4214 Davenport St
Omaha, NE 68131-2242

Phone

(330) 687-5108

NPI assigned

Jun 28, 2023

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

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Platte Nebraska Hospital CorporationGroup PAC ID 6507856697, 237 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Great Plains Health Hospital, North Platte, NE, CCN 280065
• Ogallala Community Hospital Hospital, Ogallala, NE, CCN 281355

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• North Platte Nebraska Hospital Corporation

  • General Acute Care Hospital
  • North Platte, NE
  • NPI 1700855533
  Medicare reassignment Care Compare group NPD (past)
• North Platte Nebraska Hospital Corporation

  • Medical Oncology Physician
  • North Platte, NE
  • NPI 1134355332
  NPD

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

• North Platte Nebraska Hospital Corporation

  • General Acute Care Hospital
  • North Platte, NE
  • NPI 1700855533
  Care Compare affiliation
• North Platte Nebraska Hospital Corporation

  • Clinical Medical Laboratory
  • North Platte, NE
  • NPI 1902660509

  Hospital

  Care Compare affiliation
• Ogallala Community Hospital

  • Critical Access Hospital
  • Ogallala, NE
  • NPI 1710915467
  Care Compare affiliation

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1922785336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 DAVENPORT ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312242",
            "telephone_number": "330-687-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4214 DAVENPORT ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312242",
            "telephone_number": "330-687-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-28",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janiece Wilson
• Janiya Wilson
• Jason Wilson
• Jeanette A Wilson
• Jodi Wilson, MSSW
• Julyah Wilson
• Kallan Wilson
• Karen Borchman Wilson, OD
• Karisa Wilson
• Kelly Wilson

• Physician Assistant in Omaha, NE
• Providers in Omaha, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.