JOHN A WILDER PH.D.
NPI 1164517819
Psychologist in Charlotte, NC

Active since October 04, 2006PECOS Enrolled
14818 CAPRICORN LN, CHARLOTTE, NC 28277(704) 517-2138 Get Directions Write a Review

NPPES record last updated: February 27, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About John A Wilder Ph.d. NPPES

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

JOHN A WILDER PH.D. (NPI 1164517819) is an individual psychologist in Charlotte, North Carolina, licensed in North Carolina (3005) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164517819
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameJOHN A WILDERCredential: PH.D.
Location Address14818 CAPRICORN LNCharlotte, NC 28277-2927
Mailing Address13575 58th St N, Suite 187Clearwater, FL 33760-3740 · (800) 632-6074
Sole ProprietorNo
Enumeration DateOctober 4, 2006
Last NPPES UpdateFebruary 27, 2020
✔ NPI 1164517819 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in NC · 3005
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License P3005 (NC)
14818 CAPRICORN LN, Charlotte, NC 28277

Other Names 1

Other Name (5)Jay Wilder Ph.d.

Other Identifiers 2

OtherP00316181NC · Rr Medicare # - Paradigm
Medicaid6000785NC

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

John A Wilder Ph.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 Reassignments

3

Medicare enrollment records show John Wilder reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Internal Medicine
1285 W A ST
Kannapolis, NC 28081
  • Reassigned Medicare billing, North Carolina enrollment
  • 160 clinicians in this Medicare group
Federally Qualified Health Center (FQHC)
90 GUARDIAN CT
Rocky Mount, NC 27804
  • Reassigned Medicare billing, North Carolina enrollment
  • 45 clinicians in this Medicare group
Hospitalist
10101 LAGRIMA DE ORO RD NE
Albuquerque, NM 87111
  • Reassigned Medicare billing, North Carolina enrollment
  • 155 clinicians in this Medicare group

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

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 John Wilder's NPI number?

The NPI number for John Wilder is 1164517819. It was assigned to this individual provider in the NPPES registry on October 4, 2006. The provider is also known as Jay Wilder Ph.D..

Where is John Wilder located?

John Wilder practices at 14818 Capricorn Ln, Charlotte, NC 28277. The listed phone number is (704) 517-2138.

What is John Wilder's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is John Wilder enrolled in Medicare?

Yes. John Wilder is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for John Wilder's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Wilder reassigns Medicare benefits to 3 organizations: Inpatient Consultants Of North Carolina, PC (Kannapolis, NC), Opportunities Industrialization Center, Inc. (Rocky Mount, NC) and Nm Pacs 2 LLC (Albuquerque, NM). Each 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 John Wilder's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does John Wilder accept?

Health plans from Blue Cross and Blue Shield of NC, Cigna Healthcare and UnitedHealthcare list John Wilder 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 John Wilder was last updated on February 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.