Ladamian Kawon Wilson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5718 Issued in OK

Practice address

2488 E 81St St Ste 290
Tulsa, OK 74137-4265

Phone

(918) 494-2665

Fax

(918) 927-3193

NPI assigned

Nov 29, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Strength Training IncGroup PAC ID 8325948094, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Strength Training Inc

  • Physical Therapist
  • Phoenix, AZ
  • NPI 1518925569
  Medicare reassignment Care Compare group NPD
• Strength Training Inc

  • Customized Equipment (DME)
  • Phoenix, AZ
  • NPI 1356552996
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1033756804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2488 E 81ST ST STE 290",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741374265",
            "telephone_number": "918-927-3226",
            "fax_number": "918-927-3193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2488 E 81ST ST STE 290",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741374265",
            "telephone_number": "918-494-2665",
            "fax_number": "918-927-3193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6475 S Yale Ave Ste 301",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741367815",
            "country_code": "US",
            "telephone_number": "918-494-2665",
            "fax_number": "918-927-3193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LADAMIAN",
        "middle_name": "KAWON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-29",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200877830A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kellie Ann Wilson
• Kendra Wilson, DO
• Kimberly Ann Wilson, MSN, APRN-CNP, NP-C
• Kyle Andrew Wilson, D.O.
• Kylee Alexis Wilson
• Lakia Dawn Wilson, LCSW
• Laura Wilson, PHD
• Lauren Elizabeth Wilson
• Lindsey Wilson, APRN-CNP
• Lucas Wilson, PTA

• Physical Therapist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.