Sharon Rose Wallace-Wilson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11003939 Issued in FL

Practice address

8800 Andora Dr
Miramar, FL 33025-2559

Phone

(305) 335-2603

NPI assigned

Aug 28, 2019

Sex

Female

Sole proprietor

Yes

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cleopatra Gordon Pusey, MD P.a.Group PAC ID 6002946605, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sharon.wallace-wilson@135727558033412.direct.elationemr.com

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.

• Cleopatra Gordon Pusey, MD P.a.

  • Primary Care Clinic/Center
  • Pembroke Pines, FL
  • NPI 1740502228

  FL

  Medicare reassignment Care Compare group NPD
• Pembroke Pines Community Health Center Inc

  • Family Medicine Physician
  • Pembroke Pines, FL
  • NPI 1326774308
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Broward Hospital District

  • General Acute Care Hospital
  • Pembroke Pines, FL
  • NPI 1134102080

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1699323287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8800 ANDORA DR",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330252559",
            "telephone_number": "305-335-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 ANDORA DR",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330252559",
            "telephone_number": "305-335-2603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE-WILSON",
        "first_name": "SHARON",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9175068",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11003939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Walker
• Carisa Walker
• Kayandra Walker, PHARM. D
• Venessa Walker, D.C.
• Jonell Wallace-Spoon
• Latoya Walsh
• Wand Away Health, LLC
• Yun Min Wang, M.D.
• Latoya Chanel Ward, PHARM.D.
• David Matthew Ware, M.D.

• All providers in Miramar, FL
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.