Active NPI
Joshua Michael Wilson, MD
- Physical Medicine & Rehabilitation Physician
- Seattle, WA
National Provider Identifier
1114263340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 61293903
- Practice address
- 1959 NE Pacific St Main Hospital
Seattle, WA 98195-2234 - Phone
- (206) 598-3300
- NPI assigned
- Dec 15, 2012
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 303164 | NC | |
| Physical Therapy Assistant | 225200000X | 2860 | SC | |
| Physical Medicine & Rehabilitation Physician | 208100000X | 61293903 | WA | Primary |
Addresses
Primary practice location
1959 NE Pacific St Main Hospital
Seattle, WA 98195-2234
Mailing address
1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (864) 404-5239
Other practice location 1
1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (864) 404-5239
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2860 | SC | MD | Prosthodontist |
| 303164 | NC | MD | Internal Medicine Physician |
| 61293903 | WA | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707350400000",
"number": "1114263340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 BLYTHE BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035812",
"telephone_number": "864-404-5239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1959 NE PACIFIC ST MAIN HOSPITAL",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981952234",
"telephone_number": "206-598-3300"
}
],
"practiceLocations": [
{
"address_1": "1000 Blythe Blvd",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282035812",
"country_code": "US",
"telephone_number": "864-404-5239",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "JOSHUA",
"middle_name": "MICHAEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-12-15",
"last_updated": "2024-02-08",
"certification_date": "2024-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "303164",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "SC",
"license": "2860",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "WA",
"license": "61293903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.