KATELYN MICHELLE WILSON (NP) – Gerontology Nurse Practitioner, NPI 1588484927

KATELYN MICHELLE WILSON (NP) is a healthcare provider. based in Springboro, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 0037888 (OH). The NPI Number for KATELYN MICHELLE WILSON (NP) is 1588484927

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
KATELYN MICHELLE WILSON (NP)
NPI
1588484927
Phone
(937) 885-0701
Address
70 REMICK BLVD
Enumeration Date
11 October 2024
Last Update Date
19 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9372943611
Graduation Year
2024 (2 years ago)
PAC ID
3971030438
Group Practice PAC ID
3173710936
Professional Enrollment ID
I20241220003543
Address ID
OH454291263KE3533XBLVD310

Contacts

FHIR Endpoint
https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/
Secure Messaging
kwilson747896@direct.ketteringhealth.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness95
Years active:1State licenses:2Other names

14,984 NURSE PRACTITIONER in OH

Provider Addresses for KATELYN MICHELLE WILSON (NP)

  • 70 REMICK BLVD

    SPRINGBORO, OH 450669168

    Phone: (937) 885-0701

    Type: Mailing

  • 3533 SOUTHERN BLVD STE 5650

    KETTERING, OH 454291263

    Phone: (937) 294-3611

    Type: Location

  • 70 Remick Blvd

    Springboro, OH 450669168

    Phone: (937) 885-0701

    Type: Location

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: 2024-12-20

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
I20241220003543INurse PractitionerOHTBD

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 45066)

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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: 3173710936View full group profile
NameSpecialtyState
Geriatric Medicine, Hematology/OncologyIL
Nurse PractitionerOH
Hematology/Oncology, Internal MedicineOH
Radiation OncologyOH
Nurse PractitionerOH
O B S T E T R I C S/ G Y N E C O L O G YOH
Orthopedic SurgeryOH
Pulmonary Disease, Critical Care (Intensivists), Sleep MedicineOH
Physician AssistantOH
Hospitalist, Emergency MedicineOH

Reviews

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Frequently asked questions

Is KATELYN MICHELLE WILSON (NP) listed with a National Provider Identifier?
Yes — KATELYN MICHELLE WILSON (NP) has NPI 1588484927 on file in the registry.
Is KATELYN MICHELLE WILSON (NP) shown as active in public data?
Registry records indicate KATELYN MICHELLE WILSON (NP) maintains an active NPI.
What area of care is associated with KATELYN MICHELLE WILSON (NP)?
KATELYN MICHELLE WILSON (NP)'s record emphasizes Gerontology Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with KATELYN MICHELLE WILSON (NP)?
Directory geography for KATELYN MICHELLE WILSON (NP) centers on Springboro, Ohio.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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