Carmen Shaw Wilson, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

4731 Issued in MA

Practice address

330 Brookline Avenue
Shapiro Building, Ground Floor, Suite Scg63
Boston, MA 02215

Phone

(617) 632-7500

NPI assigned

Jul 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Carmen Shaw Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1366928756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE BLDG GROUP",
            "address_2": "SHAPIRO BUILDING, GROUND FLOOR, SUITE SCG63",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155491",
            "telephone_number": "617-632-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVENUE",
            "address_2": "SHAPIRO BUILDING, GROUND FLOOR, SUITE SCG63",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-632-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CARMEN",
        "middle_name": "SHAW",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "4731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110171698A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARMEN",
            "last_name": "SHAW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Serita Renee Wilson-Clarke
• Margaret Marie Wilson-Murphy, MD
• Amani Wilson, PHD
• Andrew A Wilson, MD
• Annmarie C. Wilson, NP
• Carol S Wilson, NP
• Celeste Raquel Wilson, M.D.
• Charmaine Johnson Wilson, FNP-C
• Christopher Wilson, MD
• Cynthia N. Wilson, M.D.

• Audiologist in Boston, MA
• Providers in Boston, MA by specialty
• Audiologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.