KEVIN W. WILSON DO – NPI #1174633085
Internal Medicine

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

KEVIN WILSON is a physician located in BOISE, ID. NPPES has assigned the NPI number 1174633085 to KEVIN WILSON on August 30, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 207R00000X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine.

The NPI profile was previously updated about 6 years ago on Aug 13, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for KEVIN WILSON below.

NPI Profile for
KEVIN W. WILSON

NPI Number
1174633085
Enumeration Date

(about 20 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
KEVIN W. WILSON
Credentials
DO
Primary location
5966 W CURTISIAN AVE
BOISE, ID 83704
Phone: (208) 302-5400 Fax: (208) 302-5455
Mailing address
3340 E GOLDSTONE WAY
MERIDIAN, ID 83642
Phone: (208) 302-5400 Fax: (208) 302-5455
Sole Proprietor
No
Updated
Certification Date
Aug 13, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for KEVIN WILSON

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDAZ110388
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207R00000X
- Internal Medicine (Primary)
ID O-1071

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Additional Information

Affiliations
KEVIN WILSON is affiliated with the following medical group(s):
  • HOSPITAL
    • SAINT ALPHONSUS REGIONAL MEDICAL CENTER
      1055 NORTH CURTIS ROAD
      BOISE, ID 83706
    • ST LUKE'S REGIONAL MEDICAL CENTER
      190 EAST BANNOCK STREET
      BOISE, ID 83712

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