Sheresa Wilson PA-C LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

SHERESA WILSON PA-C LLC

Practice address

419 Airport North Office Park
Fort Wayne, IN 46825-6704

Phone

(260) 452-6700

NPI assigned

Feb 28, 2025

Organization subpart

No

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

Authorized official

Name

Sheresa WilsonNPI 1114001237

Title

Owner

Phone

(260) 452-6700

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sheresa Wilson, PA-C, LMHCA

  • Physician Assistant
  • Fort Wayne, IN
  • NPI 1114001237
  NPD Authorized official

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

{
    "created_epoch": "1740700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740700800000",
    "number": "1528865177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 AIRPORT NORTH OFFICE PARK",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468256704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 AIRPORT NORTH OFFICE PARK",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468256704",
            "telephone_number": "260-452-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERESA WILSON PA-C LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-28",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SHERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-452-6700"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Ashlee Shepherd
• Teri Shepherd, CMT
• Karyn Leigh Shepler, RPH
• Nancy Shepler, COTA
• John Sheppard, LCSW
• Sheri Crawford, DMD, LLC
• Annblythe Sheridan, CRNA
• Dustin John Sherman, D.C.
• Emily Sherman, MA
• Joseph Matthew Sherman, M.S., BCBA

• Psychiatry Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.