Susannah Alyse Wilson, NP

Primary specialty

Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X

License

229744 Issued in LA

Practice address

8585 Picardy Ave
Baton Rouge, LA 70809-3748

Phone

(956) 299-3727

NPI assigned

Jul 10, 2023

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

Medicare fee-for-service enrollment

Enrolled in LA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Neokids LLC

  • Neonatal-Perinatal Medicine Physician
  • Baton Rouge, LA
  • NPI 1093490807
  Medicare reassignment NPD

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1124706973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 JEANSONNE ST",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713605060",
            "telephone_number": "318-729-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8585 PICARDY AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093748",
            "telephone_number": "956-299-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SUSANNAH",
        "middle_name": "ALYSE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "LA",
            "license": "229744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saundra Ann Wilson, LPN
• Shelby Wilson, LCSW
• Shetamian Wilson
• Skylah Wilson
• Stephanie Wilson
• Tasia Roshay Wilson, P.L.P,C
• Thessalonia Wilson
• Vashon Wilson, MHS
• Venessa Nacole Wilson
• Terri Todd Wilton, LOTR

• Critical Care Neonatal Nurse Practitioner in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Critical Care Neonatal Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.