Trever Wilson

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

175121 Issued in OH

Practice address

1975 E 221St St
Euclid, OH 44117-2101

Phone

(216) 309-9768

NPI assigned

Jun 23, 2020

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Specialty

Undefined Non-Physician Type (Specify)

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Hair & Healthcare LLC

  • Non-emergency Medical Transport (VAN)
  • Euclid, OH
  • NPI 1790657708

  Licensed Practical Nurse

  NPD Authorized official

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1245856541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 E 221ST ST",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441172101",
            "telephone_number": "216-309-9768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 E 221ST ST",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441172101",
            "telephone_number": "216-309-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TREVER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "175121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Euclid",
            "affiliation": "N",
            "address_1": "1975 E 221st St",
            "city": "Euclid",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441172101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Lester Wilson, CDCA
• Shayla Wilson
• Tammy Wilson
• Tisa Wilson, LPN
• Toccara Nicole Wilson, LPN
• Yolander Wilson, LPC
• Shalon Katrice Windeth
• Alexander Ray Winegarner Jr., QBHS
• Samuel Phillip Wingfield
• Ryan Joseph Winks, D.D.S.

• Licensed Practical Nurse in Euclid, OH
• Providers in Euclid, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.