Corey Kareen Wilson

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Practice address

908 Georgia Ave
Leesburg, FL 34748-3706

Phone

(973) 289-7813

NPI assigned

Feb 9, 2022

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1326792391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1485",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327271485",
            "telephone_number": "973-289-7813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 GEORGIA AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347483706",
            "telephone_number": "973-289-7813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "COREY",
        "middle_name": "KAREEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Gabriel Williams, APRN
• Samuel Williams, OD
• Tabitha Williams
• Zena Tamara Williams
• Kaneitra L. Williamson, PA-C
• Courtney Wilson
• Katrina Wilson
• Keia Wilson
• Wings of Love
• Wings of Love of Leesburg Transport, LLC

• Developmentally Disabled Services Day Training Agency in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Developmentally Disabled Services Day Training Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.