JARED K WILSON (M.D.) – Family Medicine Physician, NPI 1902876667

JARED K WILSON (M.D.) is a healthcare provider. based in Liberty, Kentucky. specializing in FAMILY PRACTICE, EMERGENCY MEDICINE. They hold the professional credentials M.D.. They hold a License No. 32177 (KY). The NPI Number for JARED K WILSON (M.D.) is 1902876667

Main info

Male
31 Years Of Experience
Accepts Medicare Assignment
Name
JARED K WILSON (M.D.)
NPI
1902876667
Phone
(606) 787-5044
Address
112 LIBERTY SQ
Enumeration Date
25 January 2006
Last Update Date
30 November 2015

Doctor Profile

Medical School Name
UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE
Secondary Phone
6063022831
Graduation Year
1995 (31 years ago)
PAC ID
5496646390
Group Practice PAC ID
3476818519
Professional Enrollment ID
I20080226000200
Address ID
KY425013062SO2835X27XX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,718 FAMILY PRACTICE in KY

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Provider Addresses for JARED K WILSON (M.D.)

  • Liberty Square, Liberty, Clay County, Missouri, United States

    LIBERTY, KY 425393392

    Phone: (606) 787-5044

    Fax: (606) 787-5029

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $28.

Total Amount is formed as General ($28) + Research ($0) + Ownership ($0) = $28.

Last reported payment date: 2024-07-18 • Largest payer in this snapshot: ABBVIE INC. ($28).

Total Amount

$28

General + Research + Ownership

Payments

2

Total payment records

General Amount

$28

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-18

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$28
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: 2008-02-26

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
I20080226000200IFamily PracticeKYTBD

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 42539)

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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: 3476818519View full group profile
NameSpecialtyState
Internal MedicineKY
Nurse PractitionerKY
P O D I A T R YOH
Nurse PractitionerKY
Nurse PractitionerKY
Nurse PractitionerKY
Physical Medicine And RehabilitationKY
Orthopedic SurgeryKY
Nurse PractitionerKY
N E U R O S U R G E R YTN

Reviews

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Frequently asked questions

Can I verify JARED K WILSON (M.D.) with an NPI only?
You can start verification with NPI 1902876667 for JARED K WILSON (M.D.), then check state licensing separately.
Can I rely on JARED K WILSON (M.D.) being an active provider?
As of the registry snapshot, JARED K WILSON (M.D.) is marked active.
What healthcare role does JARED K WILSON (M.D.) hold?
Scheduling teams often label JARED K WILSON (M.D.) under Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What address line appears for JARED K WILSON (M.D.)?
JARED K WILSON (M.D.)'s geographic hint is Liberty, Kentucky in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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