MR. KEVIN DAVID WILSON – Physical Therapist, NPI 1104890128

MR. KEVIN DAVID WILSON is a healthcare provider. based in Miamisburg, Ohio. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. PT010461 (OH). The NPI Number for MR. KEVIN DAVID WILSON is 1104890128

Main info

Male
23 Years Of Experience
Accepts Medicare Assignment
Name
MR. KEVIN DAVID WILSON
NPI
1104890128
Phone
(937) 449-0796
Address
2835 MIAMI VILLAGE DR
Enumeration Date
15 February 2006
Last Update Date
10 September 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5133543700
Graduation Year
2003 (23 years ago)
PAC ID
4587679436
Group Practice PAC ID
0345136412
Professional Enrollment ID
I20060214000112
Address ID
OH453424587MI2835XDRXX400
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

2,263 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OH

Provider Addresses for MR. KEVIN DAVID WILSON

  • 2835 MIAMI VILLAGE DR

    MIAMISBURG, OH 453424587

    Phone: (937) 449-0796

    Fax: (937) 262-7468

    Type: Location

  • Harrison Avenue, Westwood Business District, Werk Place, Cincinnati, Hamilton County, Ohio, 45211-5716, United States

    CINCINNATI, OH 452477961

    Phone: (513) 354-3700

    Fax: (513) 354-7651

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2006-02-14

PECOS data refreshed: 2026-06-15

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
I20060214000112IPhysical Therapist In Private PracticeOHTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes50666$0
97140Therapy procedure using manual technique, each 15 minutes46954$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes44260$0
97016Application of blood vessel compression device27937$0
97530Therapy procedure using functional activities23242$0
View full utilization report →

Insurance plans in this area (ZIP 45342)

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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: 0345136412View full group profile
NameSpecialtyState
Internal MedicineOH
Physical Therapist In Private PracticeOH
Physical Therapist In Private PracticeOH
Physical Therapist In Private PracticeOH
Orthopedic SurgeryOH
Physician AssistantOH
Physical Therapist In Private PracticeOH
Physical Therapist In Private PracticeOH
N E U R O L O G YOH
-OH

Reviews

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Frequently asked questions

What is the registry number for MR. KEVIN DAVID WILSON?
The registry entry for MR. KEVIN DAVID WILSON shows NPI 1104890128.
Is MR. KEVIN DAVID WILSON's NPI status active today?
Active status means MR. KEVIN DAVID WILSON's NPI record is not deactivated in the public file.
Which specialty label fits MR. KEVIN DAVID WILSON?
NPPES ties MR. KEVIN DAVID WILSON to Physical Therapist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit MR. KEVIN DAVID WILSON in Miamisburg, Ohio?
For routing, start with Miamisburg, Ohio for MR. KEVIN DAVID WILSON, then verify phone and hours locally.
Who maintains MR. KEVIN DAVID WILSON's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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