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DR. KYLE DAVID WILSON MD, PHD
NPI 1215499488
Student in an Organized Health Care Education/Training Program in Charleston, WV

Active since April 04, 2019PECOS Enrolled
3110 MACCORKLE AVE SE, CHARLESTON, WV 25304(304) 388-7170(304) 388-6597 Get Directions Write a Review

NPPES record last updated: April 4, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Kyle David Wilson Md, Phd NPPES

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

DR. KYLE DAVID WILSON MD, PHD (NPI 1215499488) is an individual student in an organized health care education/training program in Charleston, West Virginia and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1215499488
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. KYLE DAVID WILSONCredential: MD, PHD
Location Address3110 MACCORKLE AVE SECharleston, WV 25304-1210
Mailing Address3110 Maccorkle Ave SeCharleston, WV 25304-1210 · (304) 388-7170 · Fax (304) 388-6597
Phone(304) 388-7170
Fax(304) 388-6597
Sole ProprietorNo
Enumeration DateApril 4, 2019
✔ NPI 1215499488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
3110 MACCORKLE AVE SE, Charleston, WV 25304
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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. Kyle David Wilson Md, Phd 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.

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. KARINNA HOPE ANDREWS D.O.
Obstetrics & Gynecology
3110 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 388-2068
TERESA GAYLE WAUGH RN, CDE
Registered Nurse (Diabetes Educator)
3110 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 388-5555
ADAM THOMAS CRAWFORD D.O.
Emergency Medicine
3110 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 388-7170
BRITTAIN MCJUNKIN MD
Internal Medicine (Gastroenterology)
3110 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 347-1300
DR. EMILY A.P. MONTGOMERY M.D.
Obstetrics & Gynecology
3110 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 347-1300
DR. CHRISTIAN CONSTANTINE DIAS DO
Student in an Organized Health Care Education/Training Program
3110 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 388-9948
DR. ROBERT MYLES AUSTIN D.O.
Emergency Medicine
3110 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 388-7170
MOHAMED ABDELFATTAH AHMED ARAFA M.D
Student in an Organized Health Care Education/Training Program
3110 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 388-1000

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 Kyle Wilson's NPI number?

The NPI number for Kyle Wilson is 1215499488. It was assigned to this individual provider in the NPPES registry on April 4, 2019.

Where is Kyle Wilson located?

Kyle Wilson practices at 3110 Maccorkle Ave SE, Charleston, WV 25304. The listed phone number is (304) 388-7170.

What is Kyle Wilson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kyle Wilson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Kyle Wilson was last updated on April 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.