SHANIQUE WILSON M.D. NPI 1578094264

NPI Information

  • NPI: 1578094264
  • Provider Name: SHANIQUE WILSON, M.D.
  • Classification: Internal Medicine - 207RG0100X
  • Specialization: Gastroenterology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3627 UNIVERSITY BLVD S STE 705
    JACKSONVILLE, FL
    ZIP 32216
  • Phone: (904) 398-6718

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NPI Details

Shanique Wilson, M.D. is a gastroenterology internal medicine in Jacksonville, FL with 9 years of experience. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. Shanique Wilson, M.D. NPI is 1578094264. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE
Graduation Year:2017

The provider's business location address is:

3627 UNIVERSITY BLVD S STE 705
JACKSONVILLE, FL
ZIP 32216-403
Phone: (904) 398-6718
Fax: (904) 396-0329

The NPI 1578094264 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Colonoscopy (HCPCS:NAN13)
  • Upper gastrointestinal (GI) endoscopy for acid reflux (HCPCS:NAN12)

The enumeration date for this NPI number is 3/23/2017 and was last updated on 6/19/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0100XInternal MedicineGastroenterologyME162342FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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