Deshara L Wilson

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA93749 Issued in FL

Practice address

15303 Plantation Oaks Dr Apt 2
Tampa, FL 33647-2147

Phone

(813) 802-0557

NPI assigned

Sep 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1912514829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15303 PLANTATION OAKS DR APT 2",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472147",
            "telephone_number": "813-802-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15303 PLANTATION OAKS DR APT 2",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472147",
            "telephone_number": "813-802-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DESHARA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA93749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "0557",
            "identifier": "0557",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESHARA WILSON",
            "identifier": "0557",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Joy Wilson, R.N.
• Christopher Lloyd Wilson, C.R.N.A.
• Clayton David Wilson III, LCSW
• Colin Alexander Wilson, M.D.
• David Richard Wilson II, M.D.
• Diana Lorraine Wilson, MD
• Dolores Wilson, LMT
• Donald F Wilson, M.D.
• Dwayne Wilson, M.D.
• Gwennaelle Armelle Wilson, M.D., M.P.H.

• Massage Therapist in Tampa, FL
• Providers in Tampa, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.