VIVIAN L WILSON (M.D.) – Family Medicine Physician, NPI 1386753945

VIVIAN L WILSON (M.D.) is a healthcare provider. based in Oklahoma city, Oklahoma. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. 11902 (OK). The NPI Number for VIVIAN L WILSON (M.D.) is 1386753945

Main info

Female
49 Years Of Experience
Accepts Medicare Assignment
Name
VIVIAN L WILSON (M.D.)
NPI
1386753945
Phone
(405) 769-3301
Address
12716 N.E. 36TH STREET
Enumeration Date
29 August 2006
Last Update Date
23 January 2026

Doctor Profile

Medical School Name
UNIVERSITY OF COLORADO SCHOOL OF MEDICINE, DENVER
Secondary Phone
4057693301
Graduation Year
1977 (49 years ago)
PAC ID
1355385014
Group Practice PAC ID
4688584436
Professional Enrollment ID
I20050614000233
Address ID
OK730849167SP12716STXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Digital endpointsOther names

1,775 FAMILY PRACTICE in OK

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Provider Addresses for VIVIAN L WILSON (M.D.)

  • 36th Street Barbershop, 3705, North Meridian Avenue, Oklahoma City, Oklahoma County, Oklahoma, 73112, United States

    OKLAHOMA CITY, OK 73140

    Phone: (405) 769-3301

    Fax: (405) 769-9685

    Type: Location

  • PO BOX 30589

    12716 N.E. 36TH STREET

    MIDWEST CITY, OK 731403589

    Phone: (405) 769-3301

    Fax: (405) 769-9685

    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: 2005-06-14

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
I20050614000233IFamily PracticeOKTBD

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
83036Hemoglobin a1c level14071$0
90686Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage3332$0
G0008Administration of influenza virus vaccine3232$0
81000Manual urinalysis test with examination using microscope, non-automated2516$0
36415Insertion of needle into vein for collection of blood sample2218$0
View full utilization report →

Insurance plans in this area (ZIP 73140)

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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: 4688584436View full group profile
NameSpecialtyState
Internal MedicineOK
Family PracticeOK
Family PracticeOK
Nurse PractitionerOK
Registered Dietitian Or Nutrition ProfessionalOK
Family PracticeOK
-OK
Clinical Social WorkerOK

Reviews

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Frequently asked questions

Is VIVIAN L WILSON (M.D.) listed with a National Provider Identifier?
Yes — VIVIAN L WILSON (M.D.) has NPI 1386753945 on file in the registry.
Is VIVIAN L WILSON (M.D.) shown as active in public data?
Registry records indicate VIVIAN L WILSON (M.D.) maintains an active NPI.
What expertise is attributed to VIVIAN L WILSON (M.D.)?
VIVIAN L WILSON (M.D.)'s specialty line reads Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is VIVIAN L WILSON (M.D.) associated with Oklahoma City?
Public fields place VIVIAN L WILSON (M.D.) around Oklahoma City, Oklahoma. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for VIVIAN L WILSON (M.D.) is noted as August 29, 2006 where the registry provides it.

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