Diana Lorraine Wilson, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

077328 Issued in GA

Practice address

1209 E Cumberland Ave
Unit 2505
Tampa, FL 33602-4256

Phone

(704) 575-8825

NPI assigned

Nov 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Grady Memorial Hospital Corporation

  • Multi-Specialty Clinic/Center
  • Atlanta, GA
  • NPI 1649765686
  Medicare reassignment NPD
• Morehouse Healthcare, Inc.

  • Cardiovascular Disease Physician
  • Atlanta, GA
  • NPI 1801832324

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Grady Memorial Hospital Corporation

  • Rehabilitation Hospital
  • Atlanta, GA
  • NPI 1336961119
  NPD
• Grady Memorial Hospital Corporation

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1992799050
  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1720159692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 E CUMBERLAND AVE",
            "address_2": "UNIT 2505",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024256",
            "telephone_number": "704-575-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 E CUMBERLAND AVE",
            "address_2": "UNIT 2505",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024256",
            "telephone_number": "704-575-8825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DIANA",
        "middle_name": "LORRAINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "077328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM HEALTHKEEPERS",
            "identifier": "239379",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Lloyd Wilson, C.R.N.A.
• Clayton David Wilson III, LCSW
• Colin Alexander Wilson, M.D.
• David Richard Wilson II, M.D.
• Deshara L Wilson
• Dolores Wilson, LMT
• Donald F Wilson, M.D.
• Dwayne Wilson, M.D.
• Gwennaelle Armelle Wilson, M.D., M.P.H.
• Hannah Wilson, AU.D.

• Obstetrics & Gynecology Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2017; 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.