Individual provider Active NPI

Shonita Wilson, APRN

  • Family Nurse Practitioner
  • Georgetown, TX
National Provider Identifier
1265190987
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1087036 Issued in TX
Practice address
4945 Williams Dr
Georgetown, TX 78633-2008
Phone
(512) 819-0500
NPI assigned
Nov 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1087036 TX Primary
Registered Nurse 163W00000X 842615 TX

Addresses

Primary practice location

4945 Williams Dr
Georgetown, TX 78633-2008

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (800) 994-0371

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address swilson1359547@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL2 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
I20220803003977 TX Practitioner - Nurse Practitioner 9739561986 Reassigns benefits to 2 organizations
I20260310003217 FL Practitioner - Nurse Practitioner 9739561986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Texas a & M University System, HSC, College of Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2675 Winkler Ave
Suite 200
Fort Myers, FL 33901-9328

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
842615TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Current Accepting new patients
Scott & White Clinic CurrentSince Sep 18, 2024 Accepting new patients
Millennium Physician Group LLC CurrentSince Apr 1, 2026 Accepting new patients
Austin Geriatric Specialists, PLLC CurrentSince Jul 1, 2022 Accepting new patients
Scott & White Clinic CurrentSince Sep 18, 2024 Accepting new patients
Millennium Physician Group LLC CurrentSince Apr 1, 2026 Accepting new patients
Hni Medical Services PastSince Jul 1, 2022 Accepting new patients

Locations

9520 Bonita Beach Rd SE
Bonita Springs, FL 34135
Phone (239) 319-2195

323 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 574-3382

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

11406 Rustic Rock Dr
Austin, TX 78750
Phone (512) 251-3915

1108 Lavaca St
Ste 110320
Austin, TX 78701
Phone (512) 482-0390

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

4945 Williams Dr
Georgetown, TX 78633
Phone (512) 819-0500

1701 E Pflugerville Pkwy
Pflugerville, TX 78660
Phone (512) 259-6000

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18292/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/25850/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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 5

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": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1265190987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "800-994-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4945 WILLIAMS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786332008",
            "telephone_number": "512-819-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHONITA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-30",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1087036",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "842615",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swilson1359547@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4945 Williams Dr",
            "city": "Georgetown",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786332008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

Verify at the official NPI Registry.