MS. SHANNON L WILSON MS,RD
NPI 1336504141
Dietitian, Registered in Williamsville, NY
About Ms. Shannon L Wilson Ms,rd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. SHANNON L WILSON MS,RD (NPI 1336504141) is an individual dietitian, registered in Williamsville, New York and active in the NPI registry since December 2015.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ms. Shannon L Wilson Ms,rd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Shannon Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Williamsville, NY 14221
- Reassigned Medicare billing, New York enrollment
- 8 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
WILLIAMSVILLE, NY 14221
WILLIAMSVILLE, NY 14221
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 Shannon Wilson's NPI number?
The NPI number for Shannon Wilson is 1336504141. It was assigned to this individual provider in the NPPES registry on December 21, 2015.
Where is Shannon Wilson located?
Shannon Wilson practices at 2829 Wehrle Dr Ste 7B, Williamsville, NY 14221. The listed phone number is (716) 626-7415.
What is Shannon Wilson's specialty?
The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.
Is Shannon Wilson enrolled in Medicare?
Yes. Shannon Wilson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Shannon Wilson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shannon Wilson reassigns Medicare benefits to Custom Dietetics, PC (Williamsville, NY). 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 Shannon Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Shannon Wilson was last updated on April 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.
# Ms. Shannon L Wilson, MS,RD · NPI 1336504141
Dietitian, Registered provider in Williamsville, New York. Individual provider, active in the CMS NPPES registry since December 21, 2015.
## Identity
- **NPI:** 1336504141 (Entity type: Individual)
- **Enumerated:** December 21, 2015
- **Primary specialty:** Dietitian, Registered · taxonomy 133V00000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2829 WEHRLE DR STE 7B, Williamsville, NY 14221-7387
- **Phone:** (716) 626-7415
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Custom Dietetics, PC (NPI 1063596880, Williamsville, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 11, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1336504141) · Data from the CMS NPPES public registry.