Individual provider Active NPI

La Tisha Reed Wilson, ACNP

  • Acute Care Nurse Practitioner
  • Houston, TX
National Provider Identifier
1821245408
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
670887 Issued in TX
Practice address
6565 Fannin St
Houston, TX 77030-2703
Phone
(432) 349-2710
NPI assigned
Aug 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 670887 TX
Acute Care Nurse Practitioner 363LA2100X 670887 TX Primary

Addresses

Primary practice location

6565 Fannin St
Houston, TX 77030-2703

Mailing address

6565 Fannin St
Houston, TX 77030-2703
Phone (432) 349-2710

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
I20081029000812 TX Practitioner - Nurse Practitioner 7810056207 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Houston Methodist Specialty PhysiciansGroup PAC ID 5193239796, 1,498 clinicians
TMH Physician Associates PLLCGroup PAC ID 4486711744, 1,881 clinicians

Practice addresses (Care Compare)

6445 Main St
Suite 2500
Houston, TX 77030-1502
Phone (713) 441-3150

6565 Fannin St
Houston, TX 77030-2703

6565 Fannin St Main
577 Methodist Acad Med Assoc
Houston, TX 77030-2703
Phone (713) 441-0428

7575 San Felipe St
Suite 155
Houston, TX 77063-1777
Phone (713) 266-9955

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
670887TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TMH Physician Associates PLLC CurrentSince Feb 3, 2020 Accepting new patients
TMH Physician Associates PLLC CurrentSince Feb 3, 2020 Accepting new patients

Locations

7575 San Felipe St
Ste 155
Houston, TX 77063
Phone (713) 266-9955

6565 Fannin St
Ste B452
Houston, TX 77030
Phone (713) 441-3620

16605 Southwest Fwy
Ste 400
Sugar Land, TX 77479
Phone (281) 275-0800

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

Interoperability endpoints

  • Direct secure messaging: lwilson306378@directhoustonmethodist.org

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 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": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1821245408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302703",
            "telephone_number": "432-349-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302703",
            "telephone_number": "432-349-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LA TISHA",
        "middle_name": "REED",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-26",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "670887",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "670887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.