Active NPI
Thomas Michael Wilson, C.PED, CO
- Orthotist
- Cincinnati, OH
National Provider Identifier
1073511804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotist
- License
- LO 215
- Practice address
- 2375 Florence Ave
Cincinnati, OH 45206-2466 - Phone
- (513) 281-2800
- Fax
- (513) 281-0420
- NPI assigned
- Jul 14, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthotist | 222Z00000X | LO 215 | OH | Primary |
Addresses
Primary practice location
2375 Florence Ave
Cincinnati, OH 45206-2466
Mailing address
446 Ivy Ridge Dr
Cold Spring, KY 41076-8842
Phone (859) 781-4525
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LO 215 | OH | MD | Orthotist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rocco Prosthetic and Orthotic Center Inc | Orthotist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Prosthetic/Orthotic Supplier
- Cincinnati, OH
- NPI 1427115955
Orthotist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365465600000",
"number": "1073511804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "446 IVY RIDGE DR",
"city": "COLD SPRING",
"state": "KY",
"postal_code": "410768842",
"telephone_number": "859-781-4525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2375 FLORENCE AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452062466",
"telephone_number": "513-281-2800",
"fax_number": "513-281-0420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "THOMAS",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "C.PED, CO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-14",
"last_updated": "2013-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "OH",
"license": "LO 215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.