DR. KATHI ANN WILSON DDS
NPI 1144291477
Dentist in Grand Rapids, MI

Q: What is Kathi Wilson's NPI number?

The NPI number for Kathi Wilson is 1144291477. It was assigned to this individual provider in the NPPES registry on January 26, 2006.

Q: What is Kathi Wilson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Kathi Wilson was last updated on March 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.

Active since January 26, 2006PECOS Enrolled

4820 CASCADE RD SE, GRAND RAPIDS, MI 49546(616) 454-1482(855) 536-4347 Get Directions Write a Review

NPPES record last updated: March 11, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 11, 2025, Dec 2, 2019 (2 updates tracked since 2019).

On this page

About Dr. Kathi Ann Wilson Dds NPPES

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

DR. KATHI ANN WILSON DDS (NPI 1144291477) is an individual dentist in Grand Rapids, Michigan, licensed in Michigan (17948) and active in the NPI registry since January 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1144291477

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameDR. KATHI ANN WILSONCredential: DDS

Location Address4820 CASCADE RD SEGrand Rapids, MI 49546-3785

Mailing Address4820 Cascade Rd SeGrand Rapids, MI 49546-3785 · (616) 454-1482 · Fax (616) 454-4422

Phone(616) 454-1482

Fax(855) 536-4347

Sole ProprietorNo

Medical School CMSOtherGraduated 2000

Enumeration DateJanuary 26, 2006

Last NPPES UpdateMarch 11, 20252 updates tracked since enumeration

NPPES CertifiedMarch 11, 2025

✔ NPI 1144291477 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in MI · 17948

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

4820 CASCADE RD SE, Grand Rapids, MI 49546

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Priority Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kathi Ann Wilson Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4486792637

PECOS Enrollment IDI20091110000185

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 Kathi Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wilson Dental Care Gr PC

Same address

General Practice

4820 CASCADE RD SE STE A
Grand Rapids, MI 49546

Reassigned Medicare billing, Michigan enrollment

NPI 1598007379 (616) 454-1482

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

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of lower jaws, upper jaws and teeth 70355

An X-ray of lower jaws, upper jaws, and teeth is a diagnostic procedure that uses radiation to create images of these areas. This helps in identifying issues like tooth decay, gum problems, or jawbone irregularities. It's a quick, painless process and crucial for maintaining oral health.

44 services44 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

39 services39 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

28 services25 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

19 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49546 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

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$68.07 typical visit price

range $17.09 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment E0486

DME-Other DME · category DE000N

1 supplier31 claims31 services$1,149.97 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

SARAH CONKLIN

Licensed Practical Nurse

4820 CASCADE RD SE
GRAND RAPIDS, MI 49546

Kent County (616) 454-1482

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 Kathi Wilson's NPI number?

The NPI number for Kathi Wilson is 1144291477. It was assigned to this individual provider in the NPPES registry on January 26, 2006.

Where is Kathi Wilson located?

Kathi Wilson practices at 4820 Cascade Rd SE, Grand Rapids, MI 49546. The listed phone number is (616) 454-1482.

What is Kathi Wilson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Kathi Wilson enrolled in Medicare?

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

Which organization bills Medicare for Kathi Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kathi Wilson reassigns Medicare benefits to Wilson Dental Care Gr PC (Grand Rapids, MI). 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 Kathi Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kathi Wilson accept?

Health plans from Priority Health list Kathi 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 Kathi Wilson was last updated on March 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.