Sara A Wilson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5072 Issued in AZ

Practice address

13965 N 75TH Ave
Peoria, AZ 85381-6097

Phone

(602) 843-2991

NPI assigned

Nov 14, 2011

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 AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Integrated Rehab Consultants LLC

  • Physical Medicine & Rehabilitation Physician
  • Chicago, IL
  • NPI 1528379195

  AZ

  Medicare reassignment
• Arizona Asthma Allergy Legacy PLC

  • Allergy & Immunology Physician
  • Peoria, AZ
  • NPI 1922762699

  Physician Assistant

  NPD
• Integrated Rehab Consultants LLC

  • Physical Medicine & Rehabilitation Physician
  • Baltimore, MD
  • NPI 1316829146
  NPD
• Sjhmc Physician Services

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1326098005
  NPD (past)

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1992082390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4252 E TULSA ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852956113",
            "telephone_number": "801-721-9803",
            "fax_number": "623-935-3386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13965 N 75TH AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853816097",
            "telephone_number": "602-843-2991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3420 S Mercy Rd",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852970419",
            "country_code": "US",
            "telephone_number": "480-214-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SARA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-14",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "5072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keita Willis
• Charronda Willoughby
• Darian E Wilson, DPM
• Hyon Su Wilson, ACNPC-AG
• Nicole Wilson, COTA/L
• Stephanie Marie Wilson
• Susan Ann Wilson, RN, BSN
• Tiffany M Wilson, APRN
• Ciandra Winkels
• Courtney Nicole Winters, PA

• Medical Physician Assistant in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.