Luke Justin Wilder, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

44339 Issued in KY

Practice address

4057 Mooncoin Way
Apt 10201
Lexington, KY 40515-6088

Phone

(859) 230-6077

NPI assigned

Nov 12, 2008

Last updated

Oct 27, 2011By the provider in NPPES

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 TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  TN

  Medicare reassignment

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1982858312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4057 MOONCOIN WAY",
            "address_2": "APT 10201",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405156088",
            "telephone_number": "859-230-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4057 MOONCOIN WAY",
            "address_2": "APT 10201",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405156088",
            "telephone_number": "859-230-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "LUKE",
        "middle_name": "JUSTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-12",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "44339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wild Health Uri Clinic, LLC
• Wild Health, Inc.
• Ashley Wild
• Wildcat Pharmacist Group LLC (Hubbard and Curry Pharmacy)
• Billie Nicole Wilder, LPCC
• Mitchell Wilder, OT
• Sarah Wilder, RD
• Rebecca Wildes
• Robert Jay Wildman, PA-C
• Emory Wilds, MD

• Emergency Medicine Physician in Lexington, KY
• Providers in Lexington, KY by specialty
• Emergency Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.