NPIMap

Individual provider Active NPI

Shawn L Willson, MD

  • Neurology Physician
  • Hendersonville, NC
National Provider Identifier
1952502544
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2017-01998 Issued in NC
Practice address
840 Fleming St Ste 3
Hendersonville, NC 28791-3541
Phone
(913) 948-1340
Fax
(828) 595-9499
NPI assigned
May 30, 2007
Last updated
Apr 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X DR.0036177 CO
Neurology Physician 2084N0400X 2017-01998 NC Primary

Addresses

Primary practice location

840 Fleming St Ste 3
Hendersonville, NC 28791-3541

Mailing address

840 Fleming St Ste 3
Hendersonville, NC 28791-3541
Phone (913) 948-1340

Other identifiers 2

IdentifierTypeStateIssuer
1952502544MedicaidMO
200599170AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0036177COMDNeurology Physician
2017-01998NCMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Smart Person LLC Current Accepting new patients
Midwest Psychiatric Consultants, P.C. PastSince Apr 20, 1998 Accepting new patients
Kansas City University Past Accepting new patients
Mercy Hospital Past Accepting new patients
Mercy Hospital Past Accepting new patients
Mercy Hospital Past Accepting new patients
Mercy Hospital Past Accepting new patients

Locations

191 E Chestnut St
Asheville, NC 28801
Phone (828) 250-0829

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588032000000",
    "number": "1952502544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 FLEMING ST STE 3",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287913541",
            "telephone_number": "913-948-1340",
            "fax_number": "828-595-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 FLEMING ST STE 3",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287913541",
            "telephone_number": "913-948-1340",
            "fax_number": "828-595-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLSON",
        "first_name": "SHAWN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "DR.0036177",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2017-01998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952502544",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200599170A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.