Tara Mahoney Wilson, MSPT, OCS, CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTP-PT-LIC-1824 Issued in MT

Practice address

2740 South Ave W Ste 101
Missoula, MT 59804-5137

Phone

(406) 543-0617

Fax

(406) 728-1085

NPI assigned

Oct 24, 2006

Last updated

May 15, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Tara M Mahoney Former name

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Rockies Orthopaedics, PLLPGroup PAC ID 6507766227, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: twilson@orthopaedic.emadirect.md

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

• Northern Rockies Orthopaedics, PLLP

  • Clinic/Center
  • Missoula, MT
  • NPI 1922008077

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Corvallis Physical Therapy, PC

  • Physical Therapy Clinic/Center
  • Corvallis, MT
  • NPI 1891080529

  Physical Therapist

  NPD (past)
• Hamilton Physical Therapy PC

  dba Corvallis Physical Therapy

  • Physical Therapy Clinic/Center
  • Hamilton, MT
  • NPI 1023057064

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1114001765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 SOUTH AVE W STE 101",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598045137",
            "telephone_number": "406-543-0617",
            "fax_number": "406-728-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 SOUTH AVE W STE 101",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598045137",
            "telephone_number": "406-543-0617",
            "fax_number": "406-728-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TARA",
        "middle_name": "MAHONEY",
        "credential": "MSPT, OCS, CSCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "PTP-PT-LIC-1824",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "MAHONEY",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lauren Sarah Wilson, M.D.
• Lennard Steven Wilson, M.D.
• Mark Wilson, DC
• Pamela C. Wilson, LCPC
• Philip Michael Wilson, D.D.S.
• Tiana Wilson, LCSW
• Tracy Louise Wilson, LCPCC
• David E Wiltfong, LCSW
• Kate Carey Wiltfong, LCSW
• Montanna Windham, LAT, ATC

• Physical Therapist in Missoula, MT
• Providers in Missoula, MT by specialty
• Physical Therapist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; 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.