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MARK DAVIS WILSON M.D.
NPI 1003132754
Pediatrics in Tifton, GA

Active since April 19, 2010PECOS Enrolled
215 12TH ST W, TIFTON, GA 31794(229) 396-5335(229) 396-5330 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 7, 2023, Oct 19, 2022, May 20, 2019 and 2 more (5 updates tracked since 2017).

About Mark Davis Wilson M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK DAVIS WILSON M.D. (NPI 1003132754) is an individual pediatrics provider in Tifton, Georgia, licensed in Georgia (069737) and active in the NPI registry since April 2010. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003132754
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameMARK DAVIS WILSONCredential: M.D.
Location Address215 12TH ST WTifton, GA 31794-3923
Mailing Address215 12th St WTifton, GA 31794-3923 · (229) 396-5335 · Fax (229) 396-5330
Phone(229) 396-5335
Fax(229) 396-5330
Sole ProprietorNo
Enumeration DateApril 19, 2010
Last NPPES UpdateMarch 7, 20235 updates tracked since enumeration
NPPES CertifiedOctober 19, 2022
✔ NPI 1003132754 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in GA · 069737
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
215 12TH ST W, Tifton, GA 31794
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Other Identifiers 1

Other69737GA · License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mark Davis Wilson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Mark Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Careconnect Health, Inc.
80 mi
Federally Qualified Health Center (FQHC)
510 ALSTON ST STE B
Richland, GA 31825
  • Reassigned Medicare billing, Georgia enrollment
  • 219 clinicians in this Medicare group
NPI 1063436624 (229) 887-3324

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31794 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIZABETH L. WILSON PNP
Nurse Practitioner (Pediatrics)
215 12TH ST W
TIFTON, GA 31794
Tift County (229) 396-5335
TIFTAREA PEDIATRICS
Pediatrics
215 12TH ST W
TIFTON, GA 31794
Tift County (912) 690-4043

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Wilson's NPI number?

The NPI number for Mark Wilson is 1003132754. It was assigned to this individual provider in the NPPES registry on April 19, 2010.

Where is Mark Wilson located?

Mark Wilson practices at 215 12th St W, Tifton, GA 31794. The listed phone number is (229) 396-5335.

What is Mark Wilson's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Mark Wilson enrolled in Medicare?

Yes. Mark Wilson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mark Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mark Wilson reassigns Medicare benefits to Careconnect Health, Inc. (Richland, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mark Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mark Wilson accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Mark Wilson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mark Wilson was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.