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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JAMES DAVID WILSON M.D.
NPI 1225002561
Family Medicine in Somerset, KY

Active since February 14, 2006PECOS EnrolledAccepts Medicare Assignment
350 HOSPITAL WAY, SUITE 100, SOMERSET, KY 42503(606) 451-2662(606) 451-2641 Get Directions Write a Review

NPPES record last updated: September 29, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About James David Wilson M.d. NPPES

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

JAMES DAVID WILSON M.D. (NPI 1225002561) is an individual family medicine provider in Somerset, Kentucky, licensed in Kentucky (28922) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Lake Cumberland Regional Hospital, and is a graduate of University Of Louisville School Of Medicine (1991).

NPPES Registry Identity

NPI1225002561
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJAMES DAVID WILSONCredential: M.D.
Location Address350 HOSPITAL WAY, SUITE 100Somerset, KY 42503-2872
Mailing Address350 Hospital Way, Suite 100Somerset, KY 42503-2872 · (606) 451-2662 · Fax (606) 451-2641
Phone(606) 451-2662
Fax(606) 451-2641
Sole ProprietorNo
Medical School CMSUniversity Of Louisville School Of MedicineGraduated 1991
Enumeration DateFebruary 14, 2006
Last NPPES UpdateSeptember 29, 2026
✔ NPI 1225002561 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in KY · 28922
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.
350 HOSPITAL WAY, Somerset, KY 42503
Open in Google Maps ↗

Other Identifiers 6

Other1183698Cha
Other5012148Aetna
OtherC92457Cumberland Healthcare
Medicaid64289226KY
Other000000054066Anthem
Other5125851Ccn

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

James David Wilson M.d. 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 ID4981737087
PECOS Enrollment IDI20100726000711
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

2

Medicare enrollment records show James Wilson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lake Cumberland Regional Hospital LLC
0.1 mi
Rural Health
305 LANGDON ST
Somerset, KY 42503
  • Reassigned Medicare billing, Kentucky enrollment
  • 89 clinicians in this Medicare group
NPI 1023155462 (606) 679-7441
Spero Health Of Kentucky, LLC
40 mi
Addiction Medicine
106 BELINDA BLVD STE 100
Danville, KY 40422
  • Reassigned Medicare billing, Kentucky enrollment
  • 115 clinicians in this Medicare group
NPI 1982102109 (866) 755-4258

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

Hospital Affiliations CMS Care Compare

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

Lake Cumberland Regional Hospital

Acute Care Hospitals · Somerset, KY
2/5 CMS rating
OwnershipProprietary
CMS Certification Number180132
Location305 Langdon StreetSomerset, KY 42503 · Pulaski County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 42503 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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 4

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
7 suppliers15 claims35 services$6.05 avg. paid by Medicare
Aerosol mask, used with dme nebulizer A7015
DME-Other DME · category DE000N
1 supplier11 claims11 services$1.08 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
2 suppliers13 claims5,520 services$0.02 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
2 suppliers13 claims13 services$19.17 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. AMR OSMAN EL-NAGGAR M.D.
Neurological Surgery
350 HOSPITAL WAY, SUITE 270
SOMERSET, KY 42503
Pulaski County (606) 678-9617
MR. RAINER ALLEN OLIVER DO
Internal Medicine
350 HOSPITAL WAY, SUITE 101
SOMERSET, KY 42503
Pulaski County (606) 451-5093
DAVID M REILLY M.D.
Family Medicine
350 HOSPITAL WAY, SUITE 100
SOMERSET, KY 42503
Pulaski County (606) 451-2601
JOSEPH G WEIGEL M.D.
Internal Medicine
350 HOSPITAL WAY, SUITE 100
SOMERSET, KY 42503
Pulaski County (606) 451-2629
MISS SUSAN MICHELE PELL ATC, PA-C
Physician Assistant
350 HOSPITAL WAY, SUITE 100
SOMERSET, KY 42503
Pulaski County (606) 451-2628
LAKE CUMBERLAND REGIONAL HOSPITAL, LLC
Thoracic Surgery (Cardiothoracic Vascular Surgery)
350 HOSPITAL WAY, SUITE 220
SOMERSET, KY 42503
Pulaski County (606) 451-0300
LAKE CUMBERLAND REGIONAL HOSPITAL LLC
Internal Medicine (Pulmonary Disease)
350 HOSPITAL WAY, SUITE 250
SOMERSET, KY 42503
Pulaski County (606) 678-0171
RICHARD F ATKINSON
Student in an Organized Health Care Education/Training Program
350 HOSPITAL WAY
SOMERSET, KY 42503
Pulaski County (630) 291-6874

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 James Wilson's NPI number?

The NPI number for James Wilson is 1225002561. It was assigned to this individual provider in the NPPES registry on February 14, 2006.

Where is James Wilson located?

James Wilson practices at 350 Hospital Way Suite 100, Somerset, KY 42503. The listed phone number is (606) 451-2662.

What is James Wilson's specialty?

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

Is James Wilson enrolled in Medicare?

Yes. James 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.

Which organizations bill Medicare for James Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Wilson reassigns Medicare benefits to 2 organizations: Lake Cumberland Regional Hospital LLC (Somerset, KY) and Spero Health Of Kentucky, LLC (Danville, KY). 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 James Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Wilson accept?

Health plans from Anthem Blue Cross and Blue Shield list James 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 James Wilson affiliated with any hospitals?

According to CMS data, James Wilson is affiliated with Lake Cumberland Regional Hospital.

When was this NPI record last updated?

The NPPES record for James Wilson was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days 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.