Demaris Wilson, NP

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

302657 Issued in NY

Practice address

425 Michigan Ave
Buffalo, NY 14203-2209

Phone

(716) 848-2122

Fax

(716) 848-2125

NPI assigned

Jul 4, 2006

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Integrative Pain & Wellness Associates, LLC

  • Pain Medicine Physician
  • Williamsville, NY
  • NPI 1689123929
  NPD
• Exigence Hospitalist Medical Services of Erie County, PLLC

  • Emergency Medicine Physician
  • Buffalo, NY
  • NPI 1366636730
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649200718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 MICHIGAN AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142032209",
            "telephone_number": "716-848-2122",
            "fax_number": "716-848-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 MICHIGAN AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142032209",
            "telephone_number": "716-848-2122",
            "fax_number": "716-848-2125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DEMARIS",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "302657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Marie Wilson-Ward, AU.D
• Antoinette Wilson
• Breeann N Wilson, DPM
• Brittany E Wilson, LPN
• Courtney Wilson
• Jalen Wilson
• Kimberley Alexandria Wilson, NP
• Lareese Wilson Dabielle Wilson, LPN
• Shaquita Marie Wilson, MSW
• Susan M. Wilson

• General Acute Care Hospital in Buffalo, NY
• Providers in Buffalo, NY by specialty
• General Acute Care Hospital in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.