Individual provider Active NPI

Dania Alexa Wilson, NP

  • Adult Health Nurse Practitioner
  • New London, CT
National Provider Identifier
1164856035
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN01341 Issued in RI
Practice address
194 Howard St
New London, CT 06320-5544
Phone
(860) 444-4737
Fax
(860) 865-2375
NPI assigned
Aug 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN01341 RI Primary

Addresses

Primary practice location

194 Howard St
New London, CT 06320-5544

Mailing address

194 Howard St
New London, CT 06320-5544
Phone (860) 444-4737

Other practice location 1

45 Wells St Ste 104
Westerly, RI 02891-2927
Phone (860) 444-4737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, CT2 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

Enrollment IDStateProvider typePAC IDDetails
I20150417000056 RI Practitioner - Nurse Practitioner 6709001860 Reassigns benefits to 1 organization
I20200226001168 CT Practitioner - Nurse Practitioner 6709001860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

194 Howard St
New London, CT 06320-5544
Phone (860) 444-3366

45 E Ave
Westerly, RI 02891-3113
Phone (401) 637-4186

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8650CTMDSocial Worker
APRN01341RIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Mar 2, 2020 Accepting new patients

Locations

194 Howard St
New London, CT 06320
Phone (860) 442-0564

91 Voluntown Rd
Pawcatuck, CT 06379
Phone (860) 599-5477

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

45 Wells St
Ste 104
Westerly, RI 02891
Phone (401) 348-0008

45 Wells St
Westerly, RI 02891
Phone (401) 348-0008

45 East Ave
Westerly, RI 02891
Phone (401) 596-6000

Interoperability endpoints

  • Direct secure messaging: dwilson451737@direct.ynhh.org

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1164856035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 HOWARD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205544",
            "telephone_number": "860-444-4737",
            "fax_number": "860-865-2375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 HOWARD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205544",
            "telephone_number": "860-444-4737",
            "fax_number": "860-865-2375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 Wells St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Westerly",
            "state": "RI",
            "postal_code": "028912927",
            "country_code": "US",
            "telephone_number": "860-444-4737",
            "fax_number": "860-865-2375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DANIA",
        "middle_name": "ALEXA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-28",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "RI",
            "license": "APRN01341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.