KIMBERLY SHANNON WILSON PHD
NPI 1316091119
Psychologist in Knoxville, TN

Active since January 22, 2007PECOS EnrolledAccepts Medicare Assignment
5401 KINGSTON PIKE, STE 170, KNOXVILLE, TN 37919(865) 584-4005(865) 584-5551 Get Directions Write a Review

NPPES record last updated: August 17, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kimberly Shannon Wilson Phd NPPES

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

KIMBERLY SHANNON WILSON PHD (NPI 1316091119) is an individual psychologist in Knoxville, Tennessee, licensed in Tennessee (P0000002498) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS and is a graduate of University Of Tennessee, Hsc, College Of Medicine (2001).

NPPES Registry Identity

NPI1316091119
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameKIMBERLY SHANNON WILSONCredential: PHD
Location Address5401 KINGSTON PIKE, STE 170Knoxville, TN 37919-5022
Mailing Address813 S Northshore Dr, Ste 105Knoxville, TN 37919-7594 · (865) 584-4005 · Fax (865) 584-5551
Fax(865) 584-5551
Sole ProprietorYes
Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 2001
Enumeration DateJanuary 22, 2007
Last NPPES UpdateAugust 17, 2015
NPI 1316091119 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in TN · P0000002498
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.
5401 KINGSTON PIKE, Knoxville, TN 37919

Other Identifiers 2

Medicare ID-Type Unspecified3983201TN
Medicaid3983201TN

Accepted 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

Kimberly Shannon Wilson Phd 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 ID5698689552
PECOS Enrollment IDI20031114000483
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 14

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

Clinic/Center (Hearing and Speech)
5401 KINGSTON PIKE, SUITE 410
KNOXVILLE, TN 37919
Psychologist
5401 KINGSTON PIKE, TWELVE OAKS STE 410
KNOXVILLE, TN 37919
Psychologist (School)
5401 KINGSTON PIKE, 285
KNOXVILLE, TN 37919
Social Worker (Clinical)
5401 KINGSTON PIKE, SUITE 285
KNOXVILLE, TN 37919
Social Worker (Clinical)
5401 KINGSTON PIKE, SUITE 285
KNOXVILLE, TN 37919
Psychologist
5401 KINGSTON PIKE, SUITE 170
KNOXVILLE, TN 37919
Social Worker (Clinical)
5401 KINGSTON PIKE, SUITE 420
KNOXVILLE, TN 37919
Audiologist
5401 KINGSTON PIKE, SUITE 410
KNOXVILLE, TN 37919

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 Kimberly Wilson's NPI number?

The NPI number for Kimberly Wilson is 1316091119. It was assigned to this individual provider in the NPPES registry on January 22, 2007.

Where is Kimberly Wilson located?

Kimberly Wilson practices at 5401 Kingston Pike Ste 170, Knoxville, TN 37919. The listed phone number is (865) 584-4005.

What is Kimberly Wilson's specialty?

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

Is Kimberly Wilson enrolled in Medicare?

Yes. Kimberly 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 Kimberly Wilson accept?

Health plans from BlueCross BlueShield of Tennessee list Kimberly 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 Kimberly Wilson was last updated on August 17, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.