Shelby Billie Elizabeth Wildish

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

1154025674 Issued in MA

Practice address

800 Washington St # 22
Boston, MA 02111-1552

Phone

(617) 636-0265

Fax

(617) 636-8315

NPI assigned

Mar 28, 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 MA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: shelby.wildish.1@28541.direct.athenahealth.com

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1154025674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST # 22",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-0265",
            "fax_number": "617-636-8315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST # 22",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-0265",
            "fax_number": "617-636-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDISH",
        "first_name": "SHELBY",
        "middle_name": "BILLIE ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-28",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "1154025674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikolas Sandquist Wilde, PA-C
• Elisabeth J. Wilder, M.D.
• Fatima G Wilder, M.D.
• Jayme Lynn Wilder, MD
• Lindsey Wilder, MED
• Heather Davon Wildman
• Timothy Edwin Wilens, MD
• Dara Leah Wilensky
• Aidan Patrick Wiley
• Katherine Elizabeth Wiley, LICSW

• Obstetrics & Gynecology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Obstetrics & Gynecology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.