Active NPI
Cheryl Busbice Wilson, L.C.S.W.
- Clinical Social Worker
- Nacogdoches, TX
National Provider Identifier
1457407355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 02215
- Practice address
- 3516 NE Stallings Dr
Nacogdoches, TX 75965-8732 - Phone
- (936) 569-6562
- NPI assigned
- Jan 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 02215 | TX | Primary |
Addresses
Primary practice location
3516 NE Stallings Dr
Nacogdoches, TX 75965-8732
Mailing address
PO Box 630325
Nacogdoches, TX 75963-0325
Phone (936) 569-6562
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100707000308 | TX | Practitioner - Clinical Social Worker | 1850422957 | Practice locations: Nacogdoches, TX |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1974
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3516 Nestallings Dr
Nacogdoches, TX 75965-8732
Phone (936) 569-6562
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2215 | TX | MD | Foot & Ankle Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457407355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 630325",
"city": "NACOGDOCHES",
"state": "TX",
"postal_code": "759630325",
"telephone_number": "936-569-6562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3516 NE STALLINGS DR",
"city": "NACOGDOCHES",
"state": "TX",
"postal_code": "759658732",
"telephone_number": "936-569-6562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CHERYL",
"middle_name": "BUSBICE",
"name_prefix": "Mr.",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "02215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nacogdoches, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.