Beverly A Wilson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

LNO3734 Issued in AL

Practice address

1303 Dr. Martin L King Jr Ave
Mobile, AL 36603

Phone

(251) 432-4117

Fax

(251) 964-4012

NPI assigned

Oct 2, 2006

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

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: bkennerson374758@direct.ochin.org

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.

• Franklin Primary Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Frisco City, AL
  • NPI 1982024402
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1487747945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 CHARLESTON ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36603",
            "telephone_number": "251-964-4011",
            "fax_number": "251-964-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 DR. MARTIN L KING JR AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36603",
            "telephone_number": "251-432-4117",
            "fax_number": "251-964-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BEVERLY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "LNO3734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6314000141",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deanna Willyerd, CRNP
• Wilmer Hall Episcopal Children'S Home
• Alecia Wilson, CRNA
• Amanda Wilson
• Ashley Wilson
• Breanna Wilson, ALC
• Brittany M Wilson, FNP
• Charles Henry Wilson IV, MD
• Daniel Wilson
• Felicia M. Wilson, MD

• Dentist in Mobile, AL
• Providers in Mobile, AL by specialty
• Dentist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.