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SHELLY FULFORD WILSON LCSW
NPI 1295461648
Social Worker - Clinical in Fernandina Beach, FL

Active since July 28, 2022PECOS EnrolledAccepts Medicare Assignment
2127 BLUE HERON CT, FERNANDINA BEACH, FL 32034(904) 206-1028 Get Directions Write a Review

NPPES record last updated: July 28, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Shelly Fulford Wilson Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHELLY FULFORD WILSON LCSW (NPI 1295461648) is an individual clinical provider in Fernandina Beach, Florida, licensed in Florida (SW10273) and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS and is a graduate of Other (1993).

NPPES Registry Identity

NPI1295461648
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSHELLY FULFORD WILSONCredential: LCSW
Location Address2127 BLUE HERON CTFernandina Beach, FL 32034-4475
Mailing Address2127 Blue Heron CtFernandina Beach, FL 32034-4475 · (904) 206-1028
Phone(904) 206-1028
Sole ProprietorYes
Medical School CMSOtherGraduated 1993
Enumeration DateJuly 28, 2022
NPPES CertifiedJuly 28, 2022
✔ NPI 1295461648 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in FL · SW10273
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
2127 BLUE HERON CT, Fernandina Beach, FL 32034
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Cigna HealthCare of Florida, Inc., Florida Blue (BlueCross BlueShield FL) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shelly Fulford Wilson Lcsw 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.

PECOS PAC ID1456796051
PECOS Enrollment IDI20240305000775
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shelly Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grow Healthcare Group PA
344 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, Florida enrollment
  • 3,079 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32034 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $56.00 – $171.84
Typical copayment $0.00 (range $14.00 – $42.96)
Most-billed visit code NA
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Shelly Wilson's NPI number?

The NPI number for Shelly Wilson is 1295461648. It was assigned to this individual provider in the NPPES registry on July 28, 2022.

Where is Shelly Wilson located?

Shelly Wilson practices at 2127 Blue Heron Ct, Fernandina Beach, FL 32034. The listed phone number is (904) 206-1028.

What is Shelly Wilson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Shelly Wilson enrolled in Medicare?

Yes. Shelly 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.

Which organization bills Medicare for Shelly Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shelly Wilson reassigns Medicare benefits to Grow Healthcare Group PA (Miami, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shelly Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shelly Wilson accept?

Health plans from Cigna HealthCare of Florida, Inc., Cigna Healthcare, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and UnitedHealthcare list Shelly Wilson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shelly Wilson was last updated on July 28, 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.