Shane Wilson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2330 Nichols St
Anchorage, AK 99508-3458

Phone

(907) 279-6617

NPI assigned

Nov 24, 2020

Sex

Male

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 AK

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Assets IncorporatedGroup PAC ID 2769823574, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Assets Incorporated

  • Mental Health Counselor
  • Anchorage, AK
  • NPI 1659490886
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1606176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1528662152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 NICHOLS ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995083458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 NICHOLS ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995083458",
            "telephone_number": "907-279-6617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHANE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-24",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Autumn Wilson, PTA
• Peggy Wilson
• Rachel Wilson
• Randall Eric Wilson
• Rebecca Lynn Wilson, M.ED.ECSE
• Shawna Wilson, ANPC
• Shelby I Wilson, P.T.
• Sheriene Estelle Wilson
• Sherrie Wilson
• Sienny B Wilson

• Mental Health Counselor in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Mental Health Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.

Verify at the official NPI Registry.