Brooklyn Dallas Wilson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN293708 Issued in GA

Practice address

11909 McAuley Dr Ste 100A2
Savannah, GA 31419-1793

Phone

(912) 354-8331

Fax

(912) 352-9782

NPI assigned

Sep 6, 2023

Last updated

Dec 7, 2023By the provider in NPPES

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Joseph's Vascular Group, LLCGroup PAC ID 6305163650, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph's Hospital - Savannah Hospital, Savannah, GA, CCN 110043

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wilsonbro@direct.sjchs.org

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.

• St. Joseph's Vascular Group, LLC

  • Vascular Surgery Physician
  • Savannah, GA
  • NPI 1164829883
  Medicare reassignment Care Compare group NPD

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

• Saint Joseph's Hospital, Inc.

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1063406684
  Care Compare affiliation

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1831975879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 ARUSHA AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314193194",
            "telephone_number": "713-294-9632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11909 MCAULEY DR STE 100A2",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191793",
            "telephone_number": "912-354-8331",
            "fax_number": "912-352-9782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BROOKLYN",
        "middle_name": "DALLAS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN293708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lashonda Wilson-Mitchell, LPN
• Angelina Wilson, LPC
• Anna Rebecca Wilson, MD
• Antionette C Wilson, DDS
• Ashley Ritter Wilson, ANP
• Candace L Wilson, MD
• Carley Ann Wilson
• Haley Wilson
• James W Wilson Jr., MD
• Jennifer Denette Wilson, LPC

• Family Nurse Practitioner in Savannah, GA
• Providers in Savannah, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.
• 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.