Individual provider Active NPI

Micallia L Wilson

  • Certified Registered Nurse Anesthetist
  • Houston, TX
National Provider Identifier
1740851377
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1109807 Issued in TX
Practice address
6720 Bertner Ave
Houston, TX 77030-2604
Phone
(823) 355-2666
NPI assigned
Jul 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9452435 FL
Certified Registered Nurse Anesthetist 367500000X 1109807 TX Primary

Addresses

Primary practice location

6720 Bertner Ave
Houston, TX 77030-2604

Mailing address

11200 SW 8TH St
Miami, FL 33199-2516

Other practice location 1

408 NE 6th St Unit 112
Fort Lauderdale, FL 33304-6400
Phone (561) 267-4642

Other practice location 2

7200 Cambridge St
Houston, TX 77030-4202
Phone (713) 798-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230220001521 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406228402 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthomed Staffing LLCGroup PAC ID 9638429178, 373 clinicians
Baylor College of MedicineGroup PAC ID 8022243971, 1,230 clinicians

Practice addresses (Care Compare)

17080 Red Oak Dr
Houston, TX 77090-2602
Phone (469) 863-9978

1919 Old Spanish TRL
Houston, TX 77054-2003

6720 Bertner Ave
Houston, TX 77030-2604

6770 Bertner Ave
Suite C 350
Houston, TX 77030-2604
Phone (713) 798-1000

7200 Cambridge St
Houston, TX 77030-4202

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9452435FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 10, 2025 Accepting new patients
Hendrick Anesthesia Network CurrentSince Feb 20, 2023 Accepting new patients
Ut Physicians Nurse Anesthetist, Certified Registered CurrentSince Jun 13, 2025 Accepting new patients
Baylor College of Medicine CurrentSince Feb 1, 2024 Accepting new patients
Orthomed Staffing LLC CurrentSince Sep 22, 2024 Accepting new patients
Baylor College of Medicine CurrentSince Feb 1, 2024 Accepting new patients
Ut Physicians CurrentSince Jun 13, 2025 Accepting new patients

Locations

1900 Pine St
Abilene, TX 79601
Phone (325) 670-4220

751 N 18th St
Abilene, TX 79601
Phone (915) 676-0557

14425 Falcon Head Blvd
#11
Austin, TX 78738
Phone (512) 900-1006

3080 College St
#T
Beaumont, TX 77701
Phone (409) 212-5002

6949 Bryant Irvin Rd
Ste 110
Ft Worth, TX 76132
Phone (817) 332-1818

17080 Red Oak Dr
Houston, TX 77090
Phone (281) 298-7441

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

7200 Cambridge St
Houston, TX 77030
Phone (713) 798-2400

6410 Fannin St
#135
Houston, TX 77030

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

6800 N MacArthur Blvd
Irving, TX 75039
Phone (972) 969-2000

4600 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (713) 853-9302

7211 Preston Rd
Ste 2100
Plano, TX 75024
Phone (469) 303-0104

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

6720 Bertner Ave
Va Hospital, TX 77030
Phone (713) 785-8537

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1740851377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11200 SW 8TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331992516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6720 BERTNER AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302604",
            "telephone_number": "823-355-2666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "408 NE 6th St Unit 112",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333046400",
            "country_code": "US",
            "telephone_number": "561-267-4642",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7200 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770304202",
            "country_code": "US",
            "telephone_number": "713-798-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICALLIA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9452435",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1109807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.