Active NPI
Desiree Wilson
- Pharmacist
- Oxford, MS
National Provider Identifier
1043886484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E07203
- Practice address
- 1912 Jackson Ave W
Oxford, MS 38655-4454 - Phone
- (662) 238-3427
- NPI assigned
- May 27, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E07203 | MS | Primary |
Addresses
Primary practice location
1912 Jackson Ave W
Oxford, MS 38655-4454
Mailing address
105 Cedar Hill Dr
Oxford, MS 38655-6128
Phone (662) 816-0941
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E07203 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mississippi CVS Pharmacy LLC | Past | Accepting new patients | |
| Mississippi CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacy
- Hattiesburg, MS
- NPI 1760404453
-
- Pharmacy
- Oxford, MS
- NPI 1922366756
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622073600000",
"number": "1043886484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 CEDAR HILL DR",
"city": "OXFORD",
"state": "MS",
"postal_code": "386556128",
"telephone_number": "662-816-0941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1912 JACKSON AVE W",
"city": "OXFORD",
"state": "MS",
"postal_code": "386554454",
"telephone_number": "662-238-3427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "DESIREE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-27",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E07203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oxford, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.