Active NPI
Stephanie Dawn Wilson, PT
- Physical Therapist
- Oklahoma City, OK
National Provider Identifier
1124335609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2913
- Practice address
- 13301 N Meridian Ave
BLDG 200
Oklahoma City, OK 73120-9369 - Phone
- (405) 843-5710
- Fax
- (405) 843-5720
- NPI assigned
- Sep 7, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2913 | OK | Primary |
Addresses
Primary practice location
13301 N Meridian Ave
BLDG 200
Oklahoma City, OK 73120-9369
Mailing address
801 Erinova Dr
Yukon, OK 73099-2149
Phone (405) 354-8690
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2913 | OK | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283817600000",
"number": "1124335609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 ERINOVA DR",
"city": "YUKON",
"state": "OK",
"postal_code": "730992149",
"telephone_number": "405-354-8690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13301 N MERIDIAN AVE",
"address_2": "BLDG 200",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731209369",
"telephone_number": "405-843-5710",
"fax_number": "405-843-5720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "STEPHANIE",
"middle_name": "DAWN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-07",
"last_updated": "2010-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "2913",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.