Destiny Deshawn Wilson, M.D

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

T0673 Issued in TX

Practice address

7777 Forest LN Ste 300
Dallas, TX 75230-2571

Phone

(972) 284-7770

NPI assigned

Mar 20, 2017

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

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: destiny.wilson.1@8042.direct.athenahealth.com
• Direct secure messaging: dwilson1052132@direct.sw.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.

• Texas Health Care, P.L.L.C.

  • Interventional Pain Medicine Physician
  • Fort Worth, TX
  • NPI 1477628873
  Medicare reassignment NPD
• Texas Health Care, P.L.L.C.

  • Family Medicine Physician
  • Fort Worth, TX
  • NPI 1821026352
  NPD
• Texas Health Care, P.L.L.C.

  • Obstetrics & Gynecology Physician
  • Haltom City, TX
  • NPI 1821145764
  NPD
• Columbia Hospital at Medical City Dallas Subsidiary LP

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1689628984
  NPD (past)

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1508307752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302571",
            "telephone_number": "972-284-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302571",
            "telephone_number": "972-284-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DESTINY",
        "middle_name": "DESHAWN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-20",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "T0673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Damalia Wilson, M.D.
• Darshawnda Sharraine Wilson, ANP
• David George Wilson, MPO, CP, LP
• Denise Wilson
• Destani Alexandria Wilson
• Donna Wilson
• Ellen Elizabeth Wilson, MD
• Ellen Scarlett Wilson, MD
• Emily Katherine Wilson, RD, LD
• Erica Lynn Wilson, PH.D.

• Pediatrics Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; 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.