Individual provider Active NPI

Stephanie Wilson, APRN

  • Adult Health Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1780164814
Registry record updated Mar 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP138496 Issued in TX
Practice address
540 Madison Oak Dr Ste 440
San Antonio, TX 78258-3922
Phone
(210) 403-3700
Fax
(210) 403-3709
NPI assigned
Aug 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP138496 TX Primary

Addresses

Primary practice location

540 Madison Oak Dr Ste 440
San Antonio, TX 78258-3922

Mailing address

19141 Stone Oak Pkwy Ste 104
San Antonio, TX 78258-3367
Phone (210) 268-0129

Other identifiers 1

IdentifierTypeStateIssuer
363L0000XOtherTXNURSE PRACTITIONER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tcpa2@ppdxdirect.com Direct Tricity Pain Associates PA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190422000306 TX Practitioner - Nurse Practitioner 5092057125 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Physician Services of Texas, P.a. CurrentSince Aug 1, 2025 Accepting new patients

Locations

424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773532800000",
    "number": "1780164814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19141 STONE OAK PKWY STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583367",
            "telephone_number": "210-268-0129",
            "fax_number": "210-314-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 MADISON OAK DR STE 440",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583922",
            "telephone_number": "210-403-3700",
            "fax_number": "210-403-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "STEPHANIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-17",
        "last_updated": "2026-03-15",
        "certification_date": "2026-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP138496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER",
            "identifier": "363L0000X",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tcpa2@ppdxdirect.com",
            "affiliation": "Y",
            "endpointDescription": "Direct",
            "affiliationName": "Tricity Pain Associates PA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "540 Madison Oak Dr Ste 440",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782583922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.