JUSTIN T WILSON – Family Nurse Practitioner, NPI 1750144275

JUSTIN T WILSON is a healthcare provider. based in King george, Virginia. specializing in NURSE PRACTITIONER. They hold a License No. 0024193809 (VA). The NPI Number for JUSTIN T WILSON is 1750144275

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
JUSTIN T WILSON
NPI
1750144275
Phone
(540) 421-6688
Address
10209 INDIANTOWN RD
Enumeration Date
6 February 2024
Last Update Date
19 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8044480198
Graduation Year
2025 (1 year ago)
PAC ID
8628571205
Group Practice PAC ID
2769546530
Professional Enrollment ID
I20250910002844
Address ID
VA225465812RU8051XWAYX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness85
Years active:2State licenses:1Digital endpointsOther names

8,307 NURSE PRACTITIONER in VA

Provider Addresses for JUSTIN T WILSON

  • 10209 INDIANTOWN RD

    KING GEORGE, VA 224853539

    Phone: (540) 421-6688

    Type: Mailing

  • 8051 PROSPERITY WAY STE 100

    RUTHER GLEN, VA 225465812

    Phone: (804) 448-0198

    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: 2025-09-10

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
I20250910002844INurse PractitionerVATBD

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

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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 22485)

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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: 2769546530View full group profile

Reviews

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Frequently asked questions

How do payers reference JUSTIN T WILSON?
For JUSTIN T WILSON, use NPI 1750144275 as the unique 10-digit identifier.
Is there an active status for JUSTIN T WILSON?
For scheduling context, JUSTIN T WILSON is shown as active in the registry.
What expertise is attributed to JUSTIN T WILSON?
JUSTIN T WILSON's specialty line reads Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is JUSTIN T WILSON located near King George?
JUSTIN T WILSON currently maps to King George, Virginia in this extract.
Does JUSTIN T WILSON accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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