Javda Miasha Wilson, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2013043631 Issued in MO

Practice address

1225 Graham Rd
Dept Emergency Medicine
Florissant, MO 63031-8012

Phone

(314) 362-9123

Fax

(314) 747-9160

NPI assigned

Dec 6, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO, IL2 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 2

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Washington University Community Specialists LLC 94 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christian Hospital Northeast Hospital, Saint Louis, MO, CCN 260180

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Washington University Community Specialists, LLC

  • Emergency Care Clinic/Center
  • Saint Louis, MO
  • NPI 1922812254

  MO

  Medicare reassignment Care Compare group NPD
• Emergency Services Midwest SC

  • Emergency Medicine Physician
  • Belleville, IL
  • NPI 1174024806

  IL, Nurse Practitioner

  Medicare reassignment NPD
• Southeastern Emergency Physicians of Memphis LLC

  • Emergency Medicine Physician
  • Alton, IL
  • NPI 1437105277

  MO, Nurse Practitioner

  Medicare reassignment NPD
• Southeastern Emergency Services of Memphis, P.C.

  • Emergency Medicine Physician
  • Chattanooga, TN
  • NPI 1164454450

  MO

  Medicare reassignment

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

• Christian Hospital Northeast- Northwest

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1639186760

  Hospital

  Care Compare affiliation
• Christian Hospital Northeast-Northwest

  • Ambulance
  • Saint Louis, MO
  • NPI 1073769329

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1124459730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-362-9123",
            "fax_number": "314-747-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 GRAHAM RD",
            "address_2": "DEPT EMERGENCY MEDICINE",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318012",
            "telephone_number": "314-362-9123",
            "fax_number": "314-747-9160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JAVDA",
        "middle_name": "MIASHA",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-06",
        "last_updated": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2013043631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1225 Graham Rd",
            "address_2": "Dept Emergency Medicine",
            "city": "Florissant",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630318012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Willowcreek Wellness & Rehabilitation LLC
• Asia Wilson, RBT
• Aubrey Linn Wilson, O.D.
• Deborah Ann Wilson
• Detreece Wilson
• Lakimyon Chantel Wilson, MA
• Monica Wilson, FNP
• Amy M Wineinger
• Melinda R Winfield
• Denisha Wings

• All providers in Florissant, MO
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.