Individual provider Active NPI

Hannia Roxanne Theodosia Wilson, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • High Point, NC
National Provider Identifier
1609762210
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2025039426 Issued in NC
Practice address
2630 Willard Dairy Rd
High Point, NC 27265-8351
Phone
(336) 907-5186
NPI assigned
Jun 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2025039426 NC Primary

Addresses

Primary practice location

2630 Willard Dairy Rd
High Point, NC 27265-8351

Mailing address

2630 Willard Dairy Rd
High Point, NC 27265-8351
Phone (336) 884-3777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260210001367 NC Practitioner - Nurse Practitioner 8527547595 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Moses H Cone Memorial Hospital Operating CorporationGroup PAC ID 6204744600, 724 clinicians

Practice addresses (Care Compare)

931 3Rd St
Greensboro, NC 27405-6967
Phone (336) 890-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025039426NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H. Cone Memorial Hospital Operating Corporation CurrentSince Dec 1, 2025 Accepting new patients
Alamance Regional Medical Center, Inc CurrentSince Dec 1, 2025 Accepting new patients
Alamance Regional Medical Center, Inc. CurrentSince Dec 1, 2025 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Dec 1, 2025 Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

931 3rd St
Greensboro, NC 27405
Phone (336) 890-2700

2630 Willard Dairy Rd
High Point, NC 27265
Phone (336) 884-3777

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1750204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1609762210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 WILLARD DAIRY RD",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658351",
            "telephone_number": "336-884-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 WILLARD DAIRY RD",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658351",
            "telephone_number": "336-907-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "HANNIA",
        "middle_name": "ROXANNE THEODOSIA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-18",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "2025039426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.