SHANE WILSON – Mental Health Counselor, NPI 1528662152

SHANE WILSON is a healthcare provider. based in Anchorage, Alaska. specializing in MENTAL HEALTH COUNSELOR. The NPI Number for SHANE WILSON is 1528662152

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
SHANE WILSON
NPI
1528662152
Phone
Not provided
Address
2330 NICHOLS ST
Enumeration Date
24 November 2020
Last Update Date
24 November 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9072796617
Graduation Year
2018 (8 years ago)
PAC ID
6406297142
Group Practice PAC ID
2769823574
Professional Enrollment ID
I20240513003546
Address ID
AK995083458AN2330XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness75
Years active:5State licenses:0Digital endpointsOther names

230 MENTAL HEALTH COUNSELOR in AK

Provider Addresses for SHANE WILSON

  • 2330 NICHOLS ST

    ANCHORAGE, AK 995083458

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-05-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240513003546IMental Health CounselorAKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 99508)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2769823574View full group profile
NameSpecialtyState
Clinical PsychologistAK
Mental Health CounselorAK
Mental Health CounselorAK
P S Y C H I A T R YAK

Reviews

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Frequently asked questions

What is the standard ID for SHANE WILSON in the U.S.?
In the U.S., SHANE WILSON is identified by NPI 1528662152.
Does the public listing show SHANE WILSON as active?
SHANE WILSON's NPI record reflects an active status in NPPES.
What services align with SHANE WILSON's listing?
SHANE WILSON's public classification highlights Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Can patients visit SHANE WILSON in Anchorage, Alaska?
For routing, start with Anchorage, Alaska for SHANE WILSON, then verify phone and hours locally.
Who maintains SHANE WILSON's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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