Sheresa Wilson, PA-C, LMHCA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10000892A Issued in IN

Practice address

2710 Lake Ave
Fort Wayne, IN 46805-5412

Phone

(260) 481-2700

Fax

(260) 969-8448

NPI assigned

Oct 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Sheresa Wilson-Devries Former name

Medicare fee-for-service enrollment

Enrolled in MI, IN, OH3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Center of Branch CountyGroup PAC ID 9335037514, shared by 7 NPIs, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Insight Hospital and Medical Center Coldwater Hospital, Coldwater, MI, CCN 230022

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: swilson152513@direct.promedica.org

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.

• Park Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Wayne, IN
  • NPI 1306897004
  Medicare reassignment NPD
• Community Health Center of Branch County

  • General Practice Physician
  • Coldwater, MI
  • NPI 1124055009
  Medicare reassignment NPD
• Promedica Multi Specialty Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1306105150
  Medicare reassignment NPD
• Sheresa Wilson PA-C LLC

  • Psychiatry Physician
  • Fort Wayne, IN
  • NPI 1528865177
  NPD Authorized official
• Parkview Health System Inc

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1932130952
  Medicare reassignment
• Park Center Inc

  • Psychiatric Hospital
  • Fort Wayne, IN
  • NPI 1457772402
  NPD
• Parkview Health System, Inc.

  • Internal Medicine Physician
  • Fort Wayne, IN
  • NPI 1952411233
  NPD
• Community Health Center of Branch County

  • Hematology & Oncology Physician
  • Coldwater, MI
  • NPI 1215964192
  NPD
• Community Health Center of Branch County

  • Internal Medicine Physician
  • Coldwater, MI
  • NPI 1306873286
  NPD
• Community Health Center of Branch County

  • Pediatric Adolescent Medicine Physician
  • Coldwater, MI
  • NPI 1619304458
  NPD
• Regio T Penna MD, PC

  • Specialist
  • Coldwater, MI
  • NPI 1245213537
  NPD
• Summit Medical Associates LLC

  • Cardiovascular Disease Physician
  • Fort Wayne, IN
  • NPI 1063517084
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community Health Center of Branch County

  • General Acute Care Hospital
  • Coldwater, MI
  • NPI 1063471639
  Care Compare affiliation

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1114001237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16311 PAGE RD",
            "city": "GRABILL",
            "state": "IN",
            "postal_code": "467419612",
            "telephone_number": "260-452-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055412",
            "telephone_number": "260-481-2700",
            "fax_number": "260-969-8448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 Beacon St",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468054749",
            "country_code": "US",
            "telephone_number": "260-373-8000",
            "fax_number": "260-373-8034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "419 Airport North Office Park",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468256704",
            "country_code": "US",
            "telephone_number": "260-267-5185",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "370 E Chicago St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Coldwater",
            "state": "MI",
            "postal_code": "490362062",
            "country_code": "US",
            "telephone_number": "517-279-5378",
            "fax_number": "517-279-5259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHERESA",
        "credential": "PA-C, LMHCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000892A",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "88001982A",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005190",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERESA",
            "last_name": "WILSON-DEVRIES",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lei Wilson, DPM
• Lindsay Wilson
• Paul D Wilson, MSSW, LMFT, MSW, LCS
• Raymond James Wilson, ATC, LAT
• Shardae Annt'E Wilson, RBT
• Sydnie Marie Wilson, LSW
• William W Wilson, MD
• Bailey Wilt
• Windhorst Enterprises LLC
• Michael Windsor Jr., LMT

• Physician Assistant in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.