Individual provider Active NPI

Diana Jean Wilson

  • Neonatal Nurse Practitioner
  • Houston, TX
National Provider Identifier
1427481613
Registry record updated Dec 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
AP111838 Issued in TX
Practice address
921 Gessner Rd
Houston, TX 77024-2501
Phone
(713) 242-3650
NPI assigned
Aug 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X AP111838 TX Primary

Addresses

Primary practice location

921 Gessner Rd
Houston, TX 77024-2501

Mailing address

6414 Fannin St Ste G125
Houston, TX 77030-1518
Phone (832) 325-7093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180919001994 TX Practitioner - Nurse Practitioner 0941551642 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP111838TXMDNeonatal Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1376265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544832000000",
    "number": "1427481613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6414 FANNIN ST STE G125",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301518",
            "telephone_number": "832-325-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 GESSNER RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242501",
            "telephone_number": "713-242-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DIANA",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-12",
        "last_updated": "2018-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TX",
            "license": "AP111838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.