Venessa Nacole Wilson

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

419152 Issued in LA

Practice address

7819 Bluebonnet Blvd Ste C
Baton Rouge, LA 70810-2836

Phone

(225) 335-8652

NPI assigned

Jan 30, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1053027482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7819 BLUEBONNET BLVD STE C",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708102836",
            "telephone_number": "225-335-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7819 BLUEBONNET BLVD STE C",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708102836",
            "telephone_number": "225-335-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "VENESSA",
        "middle_name": "NACOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "LA",
            "license": "419152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Wilson
• Susannah Alyse Wilson, NP
• Tasia Roshay Wilson, P.L.P,C
• Thessalonia Wilson
• Vashon Wilson, MHS
• Terri Todd Wilton, LOTR
• Velda S. Wiltz, LCSW
• Marcus Damon Wimberley, PA-C
• Angelique Alegria Wimberly, P.A.
• Alicia Michele Wimley

• Prosthetic/Orthotic Supplier in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Prosthetic/Orthotic Supplier in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.