Chondra Jemise Wilson, COSMETOLOGIST

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1696 Lomond St Ste 201
Winston Salem, NC 27127-2741

Phone

(757) 289-2020

NPI assigned

Jul 15, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Lux Glamorous Wigs & Company

  • Case Management Agency
  • Indian Trail, NC
  • NPI 1598377731
  NPD

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704067200000",
    "number": "1184232126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1696 LOMOND ST STE 201",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271272741",
            "telephone_number": "757-289-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1696 LOMOND ST STE 201",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271272741",
            "telephone_number": "757-289-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHONDRA",
        "middle_name": "JEMISE",
        "name_prefix": "Miss",
        "credential": "COSMETOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-15",
        "last_updated": "2024-01-01",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "NE",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COSMETOLOGY LICENSE",
            "identifier": "C63644",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.luxglamour@gmail.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "1237 Tyvola Dr # B",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282103870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Allie Thompson Wilson
• Allyson N Wilson, D.D.S.
• Brandy Wilson, LCSWA
• Caleb Price Wilson
• Cathy Lee Wilson, MSW
• Christopher Jon Wilson, PSYD, LP, HSP-P
• Christopher Samuel Wilson
• Courtney Wilson
• Damon William Wilson, PA
• Daniel Culp Wilson, MD

• Case Manager/Care Coordinator in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Case Manager/Care Coordinator in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.