DR. KENNETH SPENCER WILSON (PHD) – Counseling Psychologist, NPI 1366400707

DR. KENNETH SPENCER WILSON (PHD) is a healthcare provider. based in Bartlesville, Oklahoma. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 966 (OK). The NPI Number for DR. KENNETH SPENCER WILSON (PHD) is 1366400707

Main info

Male
25 Years Of Experience
Accepts Medicare Assignment
Name
DR. KENNETH SPENCER WILSON (PHD)
NPI
1366400707
Phone
(918) 337-6050
Address
501 S JOHNSTONE AVE
Enumeration Date
3 May 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2001 (25 years ago)
PAC ID
6002896347
Group Practice PAC ID
7113907452
Professional Enrollment ID
I20040727000424
Address ID
OK740033611BA417XXSTXX400
Telehealth
Yes
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

196 CLINICAL PSYCHOLOGIST in OK

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Provider Addresses for DR. KENNETH SPENCER WILSON (PHD)

  • 501, South Johnstone Avenue, Bartlesville, Washington County, Oklahoma, 74003, United States

    BARTLESVILLE, OK 740036638

    Phone: (918) 337-6050

    Fax: (918) 336-6061

    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)

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: 2004-07-27

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
I20040727000424IClinical PsychologistOKTBD

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
90834Psychotherapy, 45 minutes16612$0
View full utilization report →

Insurance plans in this area (ZIP 74003)

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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: 7113907452View full group profile
NameSpecialtyState
Mental Health CounselorOK
Mental Health CounselorKS
Clinical Social WorkerOK
Nurse PractitionerOK

Reviews

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Frequently asked questions

Where can patients find DR. KENNETH SPENCER WILSON (PHD)'s NPI?
You can confirm DR. KENNETH SPENCER WILSON (PHD) with NPI 1366400707; it appears in the national provider directory.
Is DR. KENNETH SPENCER WILSON (PHD) active in the national directory?
DR. KENNETH SPENCER WILSON (PHD)'s public NPI profile is in an active state.
Does DR. KENNETH SPENCER WILSON (PHD) list a primary specialty?
If you are matching referrals, note Counseling Psychologist for DR. KENNETH SPENCER WILSON (PHD). Clinical services aligned with this taxonomy classification.
Where does public data place DR. KENNETH SPENCER WILSON (PHD)?
The snapshot lists Bartlesville, Oklahoma for DR. KENNETH SPENCER WILSON (PHD); download NPPES for the complete set.
Is DR. KENNETH SPENCER WILSON (PHD) a real provider?
This page reflects official NPPES data for NPI 1366400707. Always confirm identity and privileges with the practice and licensing boards.

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