Individual provider Active NPI

Sarah Dawn Wilson, P. A. C.

  • Physician Assistant
  • Safford, AZ
National Provider Identifier
1285969329
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4492 Issued in AZ
Practice address
1300 S 20TH Ave
Safford, AZ 85546-3301
Phone
(928) 428-3122
Fax
(928) 428-7493
NPI assigned
Oct 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4492 AZ Primary

Addresses

Primary practice location

1300 S 20TH Ave
Safford, AZ 85546-3301

Mailing address

1300 S 20TH Ave
Safford, AZ 85546-3301
Phone (928) 428-3122

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151020000672 AZ Practitioner - Physician Assistant 0941519607 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gila Health ResourcesGroup PAC ID 1254327216, 28 clinicians

Practice addresses (Care Compare)

401 Burro Aly
Morenci, AZ 85540-9647
Phone (928) 865-7500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4492AZMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: sarah.wilson.1@33093.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1285969329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 S 20TH AVE",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855463301",
            "telephone_number": "928-428-3122",
            "fax_number": "928-428-7493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S 20TH AVE",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855463301",
            "telephone_number": "928-428-3122",
            "fax_number": "928-428-7493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SARAH",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "P. A. C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-07",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Safford, AZ

Sources for this page

Verify at the official NPI Registry.