Shayla Wilson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN25324 Issued in FL

Practice address

220 Barton Blvd Unit C-14
Rockledge, FL 32955-2742

Phone

(321) 241-6800

Fax

(321) 241-6890

NPI assigned

May 6, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Brevard Health Alliance Inc

  • Federally Qualified Health Center (FQHC)
  • Melbourne, FL
  • NPI 1013355726
  Medicare reassignment NPD
• Brevard Health Alliance Inc

  • Federally Qualified Health Center (FQHC)
  • Titusville, FL
  • NPI 1427363597
  NPD
• Brevard Health Alliance, Inc.

  • Community/Retail Pharmacy
  • Melbourne, FL
  • NPI 1508735150
  NPD

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1689239691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1137",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329021137",
            "telephone_number": "321-952-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 BARTON BLVD UNIT C-14",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552742",
            "telephone_number": "321-241-6800",
            "fax_number": "321-241-6890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "University Of Kentucky 740 S Limestone",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360001",
            "country_code": "US",
            "telephone_number": "859-323-2036",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14100 58th St N",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337609900",
            "country_code": "US",
            "telephone_number": "727-824-8181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHAYLA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN25324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Ruth William
• Belinda Ann Williams, BA
• Jacinta Jean Williams
• Julie Anne Wilson
• Ruth C Wilson, ARNP
• David Jason Winningham, D.O.
• William Rex Wiseman, DO
• Serina Wisnewski, APRN
• Lindsey Buescher Witzel
• Steven M. Wolff, M.D.

• Dentist in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.