DR. RANDALL EUGENE WILSON D.D.S.
NPI 1164540365
Dentist - General Practice in Swansea, IL

Q: What is Randall Wilson's NPI number?

The NPI number for Randall Wilson is 1164540365. It was assigned to this individual provider in the NPPES registry on March 26, 2007.

Q: What is Randall Wilson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Randall Wilson was last updated on September 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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 March 26, 2007PECOS Enrolled

4121 OLD COLLINSVILLE RD, SWANSEA, IL 62226(618) 236-0501(618) 222-2997 Get Directions Write a Review

NPPES record last updated: September 10, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Randall Eugene Wilson D.d.s. NPPES

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

DR. RANDALL EUGENE WILSON D.D.S. (NPI 1164540365) is an individual general practice provider in Swansea, Illinois, licensed in Illinois (019-019975) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164540365

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. RANDALL EUGENE WILSONCredential: D.D.S.

Location Address4121 OLD COLLINSVILLE RDSwansea, IL 62226-2441

Mailing Address4121 Old Collinsville RdSwansea, IL 62226-2441 · (618) 236-0501 · Fax (618) 222-2997

Phone(618) 236-0501

Fax(618) 222-2997

Sole ProprietorYes

Enumeration DateMarch 26, 2007

Last NPPES UpdateSeptember 10, 2025

NPPES CertifiedSeptember 10, 2025

✔ NPI 1164540365 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in IL · 019-019975

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

4121 OLD COLLINSVILLE RD, Swansea, IL 62226

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Randall Eugene Wilson D.d.s. 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62226 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

$88.44 typical visit price

range $56.28 – $173.35

Typical copayment $22.11 (range $14.07 – $43.33)

Most-billed visit code 99203

Established Patient

$70.42 typical visit price

range $17.51 – $139.99

Typical copayment $17.60 (range $4.37 – $34.99)

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.

Other Providers at the Same Location NPPES 3

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

DR. JEFFREY CHARLES BANKER DDS MS

Dentist (General Practice)

4121 OLD COLLINSVILLE RD
SWANSEA, IL 62226

St. Clair County (618) 236-0501

DR. LAUREN BRITTANY WILSON DMD

Dentist (General Practice)

4121 OLD COLLINSVILLE RD
SWANSEA, IL 62226

St. Clair County (618) 236-0501

RANDALL E WILSON DDS

Clinic/Center (Dental)

4121 OLD COLLINSVILLE RD
SWANSEA, IL 62226

St. Clair County (618) 236-0501

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 Randall Wilson's NPI number?

The NPI number for Randall Wilson is 1164540365. It was assigned to this individual provider in the NPPES registry on March 26, 2007.

Where is Randall Wilson located?

Randall Wilson practices at 4121 Old Collinsville Rd, Swansea, IL 62226. The listed phone number is (618) 236-0501.

What is Randall Wilson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Randall Wilson enrolled in Medicare?

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

What insurance does Randall Wilson accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 5 other insurers list Randall 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 Randall Wilson was last updated on September 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.