Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1497727218 Individual Practitioner Female Practitioner

Gwen Wilson , PA

Physician Assistant • Gallup, NM

Professional Overview & Biography Verified Profile Summary

Gwen Wilson, PA is a registered healthcare professional specializing in Physician Assistant in Gallup, NM. Practice services are available at 2111 COLLEGE DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2111 College Dr
Rehoboth Mckinley Christian Health Care Services

Gallup, NM 873015600

Telephone 5058631820
Associated Practice Facility / Clinic
🏢 Gallup Community Health Facility NPI 1336807254

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Gallup, NM

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.5 Yrs
State Avg: 13.1 Yrs
Regional Practice Density
15 Specialists

Practicing in Gallup, NM (865 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License NM 88-PA-01

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
326240 (AZ)
Medicaid State Provider ID
00093518 (NM)
Commercial Insurance / Payer ID Lovelace Health/salud
10002165 (NM)
Commercial Insurance / Payer ID Molina
PROVP16800

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

18 Associated Practitioners
Dr. Sher Ali Khan , MD

Preventive Medicine - Addiction Medicine

NPI 1104372200

Doctor of Medicine (M.D.)

NPI 1104898063

Doctor of Medicine (M.D.)

Dr. Thomas Robinson , MD

Internal Medicine

NPI 1245202357

Doctor of Medicine (M.D.)

Sanaa Baker , FAMILY NURSE PRACTIT

Nurse Practitioner - Family

NPI 1245805761

FAMILYNURSEPRACTIT

NPI 1285663658

Doctor of Medicine (M.D.)

Judy Liesveld , CNP

Nurse Practitioner

NPI 1295707651

Certified Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 09, 2007

Registered at 2111 COLLEGE DR, REHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICES, GALLUP, NM 873015600 (Tel: 5058631820)

📍
Updated Business Mailing Address July 09, 2007

Registered at 1901 REDROCK DR, PFS DEPT, GALLUP, NM 873015683 (Tel: 5058637000)

👤
Provider Name / Credentials Updated July 09, 2007

Recorded as GWEN WILSON, PA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Physician Assistant (License #88-PA-01 in NM)

🟢
Initial NPI Registration & Enumeration February 06, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1497727218
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 06, 2006
Last Update: July 09, 2007
Sole Proprietor: No

Mailing Address

1901 Redrock Dr, Pfs Dept

Gallup, NM 873015683

Phone: 5058637000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.