MARK DAVIS WILSON (M.D.) – Pediatrics Physician, NPI 1003132754
Pediatrics Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MARK DAVIS WILSON (M.D.)
215 12TH ST W
TIFTON, GA 317943923
Phone: (229) 396-5335
Fax: (229) 396-5330
Type: Mailing
PO BOX 5610
CORDELE, GA 310105610
Phone:
Type: Mailing
1909 US HIGHWAY 82 W STE 3&4
TIFTON, GA 31793
Phone: (229) 445-3509
Fax: (229) 445-3513
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 53 Open Payments records for all available years, with a total value of $966.
Total Amount is formed as General ($966) + Research ($0) + Ownership ($0) = $966.
Last reported payment date: 2024-12-24 • Largest payer in this snapshot: Supernus Pharmaceuticals, Inc. ($401).
Total Amount
$966
General + Research + Ownership
Payments
53
Total payment records
General Amount
$966
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Supernus Pharmaceuticals, Inc. | $401 |
| McKesson Medical-Surgical, Inc. | $148 |
| GlaxoSmithKline, LLC. | $147 |
| Corium, LLC | $81 |
| PFIZER INC. | $64 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2016-05-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160504001183 | I | Pediatric Medicine | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 31794)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine, Internal Medicine | NY | |
| Family Practice, General Surgery | GA | |
| Hospitalist, Internal Medicine | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| Obstetrics/Gynecology, Interventional Pain Management | GA | |
| Family Practice | IL | |
| Family Practice | GA | |
| General Practice | GA | |
| Family Practice | GA | |
| Internal Medicine | GA |
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