Individual provider Active NPI

Stephanie Ann Wilson, CMA

  • Case Manager/Care Coordinator
  • Austin, TX
National Provider Identifier
1609727759
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
1417630401 Issued in TX
Practice address
2025 Guadalupe St Ste 260
Austin, TX 78705-5642
Phone
(917) 382-0243
Fax
(315) 273-6048
NPI assigned
Feb 5, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 1417630401 TX Primary

Addresses

Primary practice location

2025 Guadalupe St Ste 260
Austin, TX 78705-5642

Mailing address

20119 Timbernook Pass
New Caney, TX 77357-1119
Phone (832) 857-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Medical Assistant

State licenses

LicenseStateTypeSpecialty
1417630401TXMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1770249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1609727759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20119 TIMBERNOOK PASS",
            "city": "NEW CANEY",
            "state": "TX",
            "postal_code": "773571119",
            "telephone_number": "832-857-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 GUADALUPE ST STE 260",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787055642",
            "telephone_number": "917-382-0243",
            "fax_number": "315-273-6048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "credential": "CMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-05",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "TX",
            "license": "1417630401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2026; 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.