Individual provider Active NPI

Sharmell O Wilson, M.D.

  • Pediatrics Physician
  • Wake Forest, NC
National Provider Identifier
1972563013
Registry record updated Jul 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
200201202 Issued in NC
Practice address
11130 Capital Blvd
Wake Forest, NC 27587-4513
Phone
(919) 488-4094
Fax
(919) 488-4096
NPI assigned
Mar 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 200201202 NC Primary

Addresses

Primary practice location

11130 Capital Blvd
Wake Forest, NC 27587-4513

Mailing address

260 Horizon Dr
Raleigh, NC 27615-4922
Phone (919) 488-0015

Other identifiers 1

IdentifierTypeStateIssuer
89132KKMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180724003089 NC Practitioner - Pediatric Medicine 6709133523 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients

Locations

500 Gateway Dr
Clayton, NC 27520
Phone (919) 488-0015

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

1005 Big Oak Ct
Knightdale, NC 27545
Phone (919) 266-5669

260 Horizon Dr
Raleigh, NC 27615
Phone (919) 488-0015

11130 Capital Blvd
Wake Forest, NC 27587
Phone (919) 488-4094

Interoperability endpoints

  • Direct secure messaging: swilson400218@direct.medicine.duke.edu

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373328000000",
    "number": "1972563013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 HORIZON DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276154922",
            "telephone_number": "919-488-0015",
            "fax_number": "919-277-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11130 CAPITAL BLVD",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275874513",
            "telephone_number": "919-488-4094",
            "fax_number": "919-488-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHARMELL",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2013-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200201202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89132KK",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

Verify at the official NPI Registry.