DOMINIQUE WILSON
NPI 1083369490
Counselor - Professional in Chisago City, MN
About Dominique Wilson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DOMINIQUE WILSON (NPI 1083369490) is an individual professional provider in Chisago City, Minnesota and active in the NPI registry since February 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2010).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dominique Wilson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CHISAGO CITY, MN 55013
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Dominique Wilson's NPI number?
The NPI number for Dominique Wilson is 1083369490. It was assigned to this individual provider in the NPPES registry on February 14, 2022.
Where is Dominique Wilson located?
Dominique Wilson practices at 11185 Lake Blvd Ste 205, Chisago City, MN 55013. The listed phone number is (952) 228-3487.
What is Dominique Wilson's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Dominique Wilson enrolled in Medicare?
Yes. Dominique Wilson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
When was this NPI record last updated?
The NPPES record for Dominique Wilson was last updated on February 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dominique Wilson · NPI 1083369490
Professional provider in Chisago City, Minnesota. Individual provider, active in the CMS NPPES registry since February 14, 2022.
## Identity
- **NPI:** 1083369490 (Entity type: Individual)
- **Enumerated:** February 14, 2022
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 11185 LAKE BLVD STE 205, Chisago City, MN 55013-9814
- **Phone:** (952) 228-3487
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Medical school:** Other, class of 2010
## Record status
- **NPPES last updated:** February 14, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1083369490) · Data from the CMS NPPES public registry.