Individual provider Active NPI

Anita D Wilson, FNP

  • Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1710904305
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
126493 Issued in MO
Practice address
11155 Dunn Rd
Div Surg Urology, Ste 202N
Saint Louis, MO 63136-6150
Phone
(314) 362-8200
Fax
(314) 454-5244
NPI assigned
Jul 17, 2006
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 126493 MO Primary

Addresses

Primary practice location

11155 Dunn Rd
Div Surg Urology, Ste 202N
Saint Louis, MO 63136-6150

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 362-8200

Other identifiers 1

IdentifierTypeStateIssuer
427561212MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20060106000011 MO Practitioner - Nurse Practitioner 2062435969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone (314) 653-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Jul 2, 2018 Accepting new patients
Washington University CurrentSince Jul 2, 2018 Accepting new patients
North County Emergency Physicians, LLP Nurse Practitioner Past Accepting new patients

Locations

1225 Graham Rd
Florissant, MO 63031
Phone (314) 653-5630

1 Barnes Hospital
#P
Saint Louis, MO 63110
Phone (314) 362-9355

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

11133 Dunn Rd
Ste 202N
Saint Louis, MO 63136
Phone (314) 653-5000

11155 Dunn Rd
Ste 202N
Saint Louis, MO 63136
Phone (314) 355-3355

660 S Euclid Ave
Saint Louis, MO 63110

660 S Euclid Ave
#8109
Saint Louis, MO 63110
Phone (314) 362-7841

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1710904305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-362-8200",
            "fax_number": "314-454-5244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11155 DUNN RD",
            "address_2": "DIV SURG UROLOGY, STE 202N",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366150",
            "telephone_number": "314-362-8200",
            "fax_number": "314-454-5244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ANITA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "126493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "427561212",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "11155 Dunn Rd",
            "address_2": "Div Surg Urology, Ste 202N",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631366150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.