Carl Wilson, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00005063 Issued in WA

Practice address

12345 Roosevelt Way NE Apt 304
Seattle, WA 98125-4867

Phone

(206) 427-7084

NPI assigned

Jun 26, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1124645932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12345 ROOSEVELT WAY NE APT 304",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981254867",
            "telephone_number": "206-427-7084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12345 ROOSEVELT WAY NE APT 304",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981254867",
            "telephone_number": "206-427-7084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CARL",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-26",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00005063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED MASSAGE THERAPIST",
            "identifier": "MA00005063",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.cdwilsonlmt.com",
            "affiliation": "N",
            "address_1": "12345 Roosevelt Way NE Apt 304",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981254867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anthony J Wilson, MB CHB
• Ashara Lanise Wilson
• Ashley Wilson
• Ashley Nicole Wilson, PHARMD.
• Breyanna Paige Wilson
• Carmen Wilson
• Charles L. Wilson, MD
• Christopher B Wilson
• Claire Elizabeth Wilson, MA, LMHCA
• Clyde H. Wilson, M.D.

• Massage Therapist in Seattle, WA
• Providers in Seattle, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; 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.