KELBY JON WILSON MD
NPI 1164872115
Family Medicine in Grangeville, ID

Q: What is Kelby Wilson's NPI number?

The NPI number for Kelby Wilson is 1164872115. It was assigned to this individual provider in the NPPES registry on June 20, 2016.

Q: What is Kelby Wilson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelby Wilson was last updated on September 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since June 20, 2016PECOS EnrolledAccepts Medicare Assignment

607 W MAIN ST, GRANGEVILLE, ID 83530(208) 983-1700(208) 983-4665 Get Directions Write a Review

NPPES record last updated: September 30, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 30, 2020, Mar 9, 2020, Jun 20, 2016 (3 updates tracked since 2016).

On this page

About Kelby Jon Wilson Md NPPES

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

KELBY JON WILSON MD (NPI 1164872115) is an individual family medicine provider in Grangeville, Idaho, licensed in Idaho (M-14749) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS, is affiliated with St Joseph Regional Medical Center, and is a graduate of University Of Nevada School Of Medicine (2016).

NPPES Registry Identity

NPI1164872115

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameKELBY JON WILSONCredential: MD

Location Address607 W MAIN STGrangeville, ID 83530-1345

Mailing Address607 W Main StGrangeville, ID 83530-1345 · (208) 983-1700 · Fax (208) 983-4665

Phone(208) 983-1700

Fax(208) 983-4665

Sole ProprietorNo

Medical School CMSUniversity Of Nevada School Of MedicineGraduated 2016

Enumeration DateJune 20, 2016

Last NPPES UpdateSeptember 30, 20203 updates tracked since enumeration

NPPES CertifiedSeptember 30, 2020

✔ NPI 1164872115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in ID · M-14749

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

607 W MAIN ST, Grangeville, ID 83530

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelby Jon Wilson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7416283460

PECOS Enrollment IDI20190729001812

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.

Areas of Expertise CMS Part B claims 3

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.

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

18 services16 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

17 services12 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

14 services13 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Joseph Regional Medical Center

Acute Care Hospitals · Lewiston, ID

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number130003

Location415 Sixth StreetLewiston, ID 83501 · Nez Perce County

Emergency services Birthing friendly

Syringa General Hospital

Critical Access Hospitals · Grangeville, ID

OwnershipGovernment - Hospital District or Authority

CMS Certification Number131315

Location607 W Main StreetGrangeville, ID 83530 · Idaho County

Emergency services

St Marys Hospital And Clinics

Critical Access Hospitals · Cottonwood, ID

OwnershipVoluntary non-profit - Private

CMS Certification Number131321

Location701 Lewiston StCottonwood, ID 83522 · Idaho County

Emergency services

Tri-State Memorial Hospital

Critical Access Hospitals · Clarkston, WA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number501332

Location1221 Highland AvenueClarkston, WA 99403 · Asotin County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83530 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

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.

Referred Medical Equipment & Supplies CMS DME claims 18

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

2 suppliers25 claims47 services$4.82 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

2 suppliers14 claims14 services$0.78 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

3 suppliers18 claims18 services$119.48 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

3 suppliers24 claims56 services$41.74 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

3 suppliers21 claims21 services$23.82 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

1 supplier25 claims25 services$21.66 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

3 suppliers43 claims178 services$3.11 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers87 claims88 services$19.60 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

1 supplier12 claims12 services$789.85 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

1 supplier84 claims85 services$17.17 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier13 claims13 services$7.42 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

2 suppliers104 claims105 services$50.21 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers130 claims131 services$111.74 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$38.23 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

2 suppliers29 claims2,910 services$0.09 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

1 supplier19 claims19 services$21.73 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers63 claims63 services$189.34 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

2 suppliers26 claims26 services$23.00 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 20

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

DR. DANIEL C GRIFFIS MD

Family Medicine

607 W MAIN ST
GRANGEVILLE, ID 83530

Idaho County (208) 983-8590

SYRINGA GENERAL HOSPITAL DISTRICT C I F

Clinic/Center (Primary Care)

607 W MAIN ST
GRANGEVILLE, ID 83530

Idaho County (208) 983-1700

SYRINGA GENERAL HOSPITAL DISTRICT HOME HEALTH

Home Health

607 W MAIN ST
GRANGEVILLE, ID 83530

Idaho County (208) 983-1700

CARDINAL HEALTH 132, LLC

Pharmacy (Community/Retail Pharmacy)

607 W MAIN ST, SUITE 100
GRANGEVILLE, ID 83530

Idaho County (208) 494-3050

TAYLOR MICHAEL BROWN MD

Family Medicine

607 W MAIN ST
GRANGEVILLE, ID 83530

Idaho County (208) 983-1700

TERESA LYNN SODERLING FNP-C

Nurse Practitioner (Family)

607 W MAIN ST
GRANGEVILLE, ID 83530

Idaho County (208) 983-8590

MELISSA LANE DPT

Physical Therapist

607 W MAIN ST
GRANGEVILLE, ID 83530

Idaho County (208) 983-1973

SYRINGA GENERAL HOSPITAL DISTRICT C I F

Hospice Care, Community Based

607 W MAIN ST
GRANGEVILLE, ID 83530

Idaho County (208) 983-1700

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 Kelby Wilson's NPI number?

The NPI number for Kelby Wilson is 1164872115. It was assigned to this individual provider in the NPPES registry on June 20, 2016.

Where is Kelby Wilson located?

Kelby Wilson practices at 607 W Main St, Grangeville, ID 83530. The listed phone number is (208) 983-1700.

What is Kelby Wilson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kelby Wilson enrolled in Medicare?

Yes. Kelby Wilson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kelby Wilson accept?

Health plans from PacificSource Health Plans and Providence Health Plan list Kelby 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.

Is Kelby Wilson affiliated with any hospitals?

According to CMS data, Kelby Wilson is affiliated with St Joseph Regional Medical Center, Syringa General Hospital, St Marys Hospital And Clinics and Tri-State Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Kelby Wilson was last updated on September 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.