Active NPI
Tearra Wilson
- Athletic Trainer
- Edmond, OK
National Provider Identifier
1023758604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 501 W 15TH St Apt 115
Edmond, OK 73013-3648 - Phone
- (405) 437-6149
- NPI assigned
- Mar 31, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
501 W 15TH St Apt 115
Edmond, OK 73013-3648
Mailing address
501 W 15TH St Apt 115
Edmond, OK 73013-3648
Phone (405) 437-6149
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648684800000",
"number": "1023758604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 W 15TH ST APT 115",
"city": "EDMOND",
"state": "OK",
"postal_code": "730133648",
"telephone_number": "405-437-6149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 W 15TH ST APT 115",
"city": "EDMOND",
"state": "OK",
"postal_code": "730133648",
"telephone_number": "405-437-6149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "TEARRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-03-31",
"last_updated": "2022-03-31",
"certification_date": "2022-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.