SAMUEL WILSON (MD) – Student in an Organized Health Care Education/Training Program, NPI 1083110514
Student in an Organized Health Care Education/Training Program
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,137 EMERGENCY MEDICINE in TN
Provider Addresses for SAMUEL WILSON (MD)
725 GLENWOOD DR STE E487
CHATTANOOGA, TN 374041173
Phone: (423) 697-0014
Fax: (423) 648-6280
Type: Mailing
2525 DESALES AVE
CHATTANOOGA, TN 374041161
Phone: (423) 697-0014
Fax: (423) 648-6280
Type: Location
University of Oklahoma - Tulsa, 4502, East 41st Street, Max Campbell V, Tulsa, Tulsa County, Oklahoma, 74135, United States
TULSA, OK 741352536
Phone:
Type: Mailing
1201 7TH ST SE
DECATUR, AL 356013337
Phone: (256) 423-2175
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: 2022-06-15
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200728003332 | I | Emergency Medicine | OK | TBD |
| I20210827000685 | I | Emergency Medicine | GA | TBD |
| I20211020001911 | I | Emergency Medicine | TN | TBD |
| I20220615001117 | I | Emergency Medicine | AL | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 384 | 361 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 83 | 79 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 49 | 46 | $0 |
| 99291 | Critical care, first 30-74 minutes | 48 | 47 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 13 | 13 | $0 |
Insurance plans in this area (ZIP 37404)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TN | |
| Emergency Medicine | SC | |
| Nurse Practitioner | AL | |
| Nurse Practitioner | AL | |
| Emergency Medicine | CO | |
| - | AL | |
| Emergency Medicine | SC | |
| Emergency Medicine | MS | |
| Nurse Practitioner | AL | |
| Nurse Practitioner | AL |
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