Shianna Wilson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

249111 Issued in AZ

Practice address

13555 W McDowell Rd Ste 101
Goodyear, AZ 85395-2625

Phone

(623) 935-4700

Fax

(623) 935-4707

NPI assigned

Feb 23, 2024

Last updated

Mar 26, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Privia Medical Group Arizona, LLCGroup PAC ID 1052328408, 94 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shianna.wilson.2@33227.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Privia Medical Group Arizona, LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1760441141

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Privia Medical Group Arizona, LLC

  • Neurology Physician
  • Phoenix, AZ
  • NPI 1245876705

  Single Specialty

  NPD
• Privia Medical Group Arizona, LLC

  • Family Medicine Physician
  • Payson, AZ
  • NPI 1740459700

  Single Specialty

  NPD
• Tele-Rheumatology Medical Associates

  dba Rheum Without Walls

  • Rheumatology Physician
  • Watsonville, CA
  • NPI 1962072819

  Single Specialty

  NPD

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

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1275399685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 E BELL RD STE 4500",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322171",
            "telephone_number": "602-633-3848",
            "fax_number": "602-633-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13555 W MCDOWELL RD STE 101",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952625",
            "telephone_number": "623-935-4700",
            "fax_number": "623-935-4707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8541 E Anderson Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852555430",
            "country_code": "US",
            "telephone_number": "602-688-2248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHIANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-23",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "249111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonja Williamson
• Sonya Grace Willis, PSY.D
• Katelyn Willsey
• Brent J Wilson, OD
• Dominique Wilson, CNM
• Window to Healing Center, Inc. (N/a)
• Windsor Palm Valley, LLC (Palm Valley Rehabilitation & Care Center)
• Dionne Symone Winn, LMSW
• Keith D Winters, PA-C
• Daniel Wolter, DMD, MS

• Family Nurse Practitioner in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; 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.