WALTER JR. WILSON (MD) – Child & Adolescent Psychiatry Physician, NPI 1821485400

WALTER JR. WILSON (MD) is a healthcare provider. based in Covington, Kentucky. specializing in PSYCHIATRY. They hold the professional credentials MD. They hold a License No. 54415 (KY). The NPI Number for WALTER JR. WILSON (MD) is 1821485400

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
WALTER JR. WILSON (MD)
NPI
1821485400
Phone
(859) 655-6100
Address
1401 MADISON AVE
Enumeration Date
21 April 2015
Last Update Date
1 April 2021

Doctor Profile

Medical School Name
STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Secondary Phone
2708861919
Graduation Year
2015 (11 years ago)
PAC ID
1254643240
Group Practice PAC ID
6608833520
Professional Enrollment ID
I20200805002592
Address ID
KY422406808HO270XXWAYX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness75
Years active:11State licenses:1Digital endpointsOther names

398 PSYCHIATRY in KY

Provider Addresses for WALTER JR. WILSON (MD)

  • 1401 MADISON AVE

    COVINGTON, KY 410113313

    Phone: (859) 655-6100

    Type: Mailing

  • 215 E 11TH ST

    NEWPORT, KY 410712203

    Phone: (859) 655-6100

    Type: Mailing

  • 1401 Madison Ave

    Covington, KY 410113313

    Phone: (859) 655-6100

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $21.

Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.

Last reported payment date: 2023-04-06 • Largest payer in this snapshot: Supernus Pharmaceuticals, Inc. ($21).

Total Amount

$21

General + Research + Ownership

Payments

1

Total payment records

General Amount

$21

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-04-06

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2020-08-05

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200805002592IPsychiatryKYTBD

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.

Verify on CMS Revalidation Lookup Tool

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 41011)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6608833520View full group profile
NameSpecialtyState
P S Y C H I A T R YOH
Nurse PractitionerIN
P S Y C H I A T R YKY
Psychiatry, Internal MedicineTN
Nurse PractitionerTN
P S Y C H I A T R YKY

Reviews

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Frequently asked questions

What number should I use to identify WALTER JR. WILSON (MD) for billing?
Administrative and clinical systems typically use NPI 1821485400 for WALTER JR. WILSON (MD).
Does the public listing show WALTER JR. WILSON (MD) as active?
WALTER JR. WILSON (MD)'s NPI record reflects an active status in NPPES.
What type of care does WALTER JR. WILSON (MD) provide?
WALTER JR. WILSON (MD)'s profile centers on Child & Adolescent Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Can patients visit WALTER JR. WILSON (MD) in Covington, Kentucky?
For routing, start with Covington, Kentucky for WALTER JR. WILSON (MD), then verify phone and hours locally.
Can I export WALTER JR. WILSON (MD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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