Pelvic Wisdom, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PELVIC WISDOM, LLC

Practice address

222 Auburn St Ste 103
Portland, ME 04103-6005

Phone

(207) 200-6293

NPI assigned

Mar 23, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Emily Katherine Wilson, DPT

Title

Physical Therapist

Phone

(973) 885-1661

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1093391617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 AUBURN ST STE 103",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041036005",
            "telephone_number": "207-200-6293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 AUBURN ST STE 103",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041036005",
            "telephone_number": "207-200-6293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELVIC WISDOM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "KATHERINE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "973-885-1661",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962860585",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Pelletier, DO
• Kelly A Pelletier, BCBA
• Kimberly Ann Pelletier
• Avery Thomas Pellnat, MD
• Ian Harris Pelto
• Joan Pendexter, PNP
• Frances Pendleton, DDS
• Yordan Penev, MD
• Kathryn E. Penge, SP
• Anna Victoria Penkiunas

• Physical Therapy Clinic/Center in Portland, ME
• Providers in Portland, ME by specialty
• Physical Therapy Clinic/Center in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.