Lucas Bo Wilson, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT30275 Issued in CA

Practice address

405 Redcliff Dr
Suite 100
Redding, CA 96002-0157

Phone

(530) 246-2467

NPI assigned

Aug 23, 2006

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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shasta Orthopedics and Sports Medicine a Medical CorporationGroup PAC ID 3375533276, 36 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.52 of 100Reported as group

Quality

92.31

Improvement activities

40

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.

• Shasta Orthopedics & Sports Medicine a Medical Corporation

  dba Shasta Orthopaedics and Sports Medicine

  • Orthopaedic Surgery Physician
  • Redding, CA
  • NPI 1750493979
  Medicare reassignment Care Compare group NPD
• Apogee Outpatient Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Redding, CA
  • NPI 1912094509
  NPD (past)

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053428698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 REDCLIFF DR",
            "address_2": "SUITE 100",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960020157",
            "telephone_number": "530-246-2467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 REDCLIFF DR",
            "address_2": "SUITE 100",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960020157",
            "telephone_number": "530-246-2467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LUCAS",
        "middle_name": "BO",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT30275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daretta Dee Wilson
• Denise Kay Wilson, CADC-CAS
• Hannah Wilson, MA
• Jenifer Denise Wilson, LMFT
• Kristin Wilson
• Rex Duane Wilson, M.D.
• Rhobellie Florendo Wilson, PT
• Sandra A Wilson, MA
• Sarah Wilson, LVN
• Shawn Kevin Wilson, DDS

• Physical Therapist in Redding, CA
• Providers in Redding, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.